Running Head LIMITED ACCESS TO HEALTHCARE1LIMITED ACCESS TO.docx

Running Head: LIMITED ACCESS TO HEALTHCARE1
LIMITED ACCESS TO HEALTHCARE6
Limited Access to Healthcare
Arnaldo Perez-Frometa
Capella University
Developing a Health Care Perspective
Access to healthcare services is very essential for sustainable
level of living and good health. Several scholars have described
access as “the timely use of personal health services to achieve
the best possible health outcomes”. One of the issues
facing many countries across the world including those with
systems for universal healthcare is providing appropriate and
timely healthcare access for deprived patients. Currently there
is limited information on how those patients living in a context
of social and material deprivation perceive obstructions in the
system of healthcare. In this paper we shall discuss several
resources addressing the issue of access to services in the
healthcare system.
According to Andersen, Davidson, & Baumeister (2014), in

their article titled “improving the access to care”, access refers
to the actual utility of individual services for heath as well as
everything else that can facilitate or impede their use. In this
article they present research and policy issues as well as basic
trends which are related to evaluating and monitoring the access
to healthcare services. They show how evaluating and
monitoring offers the platform for the prediction of health
services, promotion of social justice and the improvement of
efficiency and effectiveness for the delivery of health services.
They analyzed access and healthcare outcomes using a
behavioral model which provides a systematic framework of
individual and contextual framework
They expanded the behavioral model by emphasizing on two
new aspects. They include the life quality as an input and
healthcare outcome and genetics as a factor for predisposing.
They also examined some examples of access indicators which
include efficiency and effectiveness measures, utilization,
potential access and healthcare needs. Changes that occurred in
these indicators over time were tracked using trend data. Finally
they did observations on access and the present status as well as
new areas of improving access via ACA which has played a big
role in improving access to health care.
Next we are going to analyze the article written by Acharya et
al., (2017) titled “Partnerships in mental healthcare service
delivery in low-resource settings: developing an innovative
network in rural Nepal”. This article provides an understanding
on the contribution of mental illness on the worldwide burden
diseases which are non communicable. However, the authors
note that there has been an extremely limited access to
ethnically sensitive, appropriately contextual and high quality
service for mental healthcare. Despite the availability for
interventions to improve outcomes for the patients, this
situation still persists. The authors suggest that there is need for
the development of partnerships network for adaptation of
programs and their implementations. They hope that people will
understand the contribution of mental illness on the global

burden of non communicable diseases.
We shall now analyze the article written by Bozorgmehr &
Razum, (2015), titled “Effect of restricting access to health care
on health expenditures among asylum-seekers and refugees: a
quasi-experimental study in Germany”. This article gives an
understanding on how immigrants and asylum seekers access
health care in Germany. The authors point out that health
services for these groups of people are restricted for a while
before being granted regular access which leads to increased
costs of healthcare and delayed care. They analyzed both the
impacts of limited access and most strategy reforms on
expenditures involving health incidences for AS&R. They
concluded that excluding AS&R, the cost of healthcare is higher
compared to granting regular access to healthcare. Excess
expenditures were as a result of restrictions and could not be
extensively explained by differences in need since they were
substantial.
The article titled “Income-related inequalities and inequities in
health care services utilization in 18 selected OECD countries”
and written by Devaux, (2015), discusses the impacts of policies
in healthcare accessibility. The author reexamines inequities
related to income in visits by doctors in eighteen selected
countries. For the first time, there is the consideration of
inequalities in preventive care services. Inequities and
inequalities are gauged using concentration indexes and the
estimation of needed adjustments for HCSU are achieved the
indirect standardization procedure. The author concludes that
inequalities in HCSU are still there in OECD Nations. In
majority of these nations, individuals with higher wages are
more likely to access healthcare services compare to those who
earn less.
The article titled “Cloud-based adaptive compression and secure
management services for 3D healthcare data”, and written by
Castiglione et al (2015), outlines the influence of technology on
healthcare accessibility. According to the author some of the
major causes of errors in the healthcare sector are shared data

and lack of access to resources. If two departments in the same
organization share information then there will be confusion.
Using three dimension images plays a great role in reducing this
confusion. In the medical environment, three dimensional
images play a fundamental role given their big sizes.
These images communicate a lot of information just by a single
glance. Software for these images needs to be managed by
medical applications in order to provide secure flexible and
effective access to healthcare resources. Users can easily access
this information in the institutions portal. The author shows
how architecture resulting from this software with totally
heterogeneous and different software and hardware
characteristics can effectively interact, thus increasing
healthcare accessibility by the end user.
According to Islam et al., (2015) in the article titled “The
internet of things for health care: a comprehensive survey”, the
internet of things can improve the access healthcare services.
This article surveys progress in internet of things base on
technologies in healthcare and reviews industrial trades,
applications and the state of art platforms in healthcare
solutions based on internet of things. This article also proposes
an intelligent inclusive security model to reduce risk of
security. Additionally, the article outlines internet of thing
privacy and security features which includes threat models and
requirements of security in the context of healthcare. Finally the
paper discusses how several innovations such as wearable,
ambient intelligence and big data can be leveraged from the
perspective of healthcare.
By going through scholarly articles, I gathered essential
scholarly opinions and facts about limited access to healthcare.
I also enhanced my knowledge about this topic. For instance
after reading the paper titled “Income-related inequalities and
inequities in health care services utilization in 18 selected
OECD countries” by Devaux, (2015), I was able to learn about
the effects of policies in access to health care something that I
didn’t know before this study. I also learnt how we can enhance

access to healthcare. This research has also enabled me to build
a repository of resources related to healthcare accessibility. It
will be easier for me now to choose relevant recourses while
writing the papers concerning healthcare accessibility.
References
Andersen, R. M., Davidson, P. L., & Baumeister, S. E. (2014).
Improving access to care. Changing the US health care system:
key issues in health services policy and management. San
Francisco: Jossey-Bass, 33-69.
Acharya, B., Maru, D., Schwarz, R., Citrin, D., Tenpa, J.,
Hirachan, S., ... & Kohrt, B. (2017). Partnerships in mental
healthcare service delivery in low-resource settings: developing
an innovative network in rural Nepal. Globalization and
health, 13(1), 2.
Bozorgmehr, K., & Razum, O. (2015). Effect of restricting
access to health care on health expenditures among asylum-
seekers and refugees: a quasi-experimental study in Germany,
1994–2013. PloS one, 10(7), e0131483.
Devaux, M. (2015). Income-related inequalities and inequities
in health care services utilisation in 18 selected OECD
countries. The European Journal of Health Economics, 16(1),
21-33.
Castiglione, A., Pizzolante, R., De Santis, A., Carpentieri, B.,
Castiglione, A., & Palmieri, F. (2015). Cloud-based adaptive
compression and secure management services for 3D healthcare
data. Future Generation Computer Systems, 43, 120-134.
Islam, S. R., Kwak, D., Kabir, M. H., Hossain, M., & Kwak, K.
S. (2015). The internet of things for health care: a
comprehensive survey. IEEE Access, 3, 678-708.

Running head: ANALYZE A CURRENT HEALTH CARE
PROBLEM OR ISSUE 1
Copyright ©2018 Capella University. Copy and distribution of
this document are prohibited.
Analyze a Current Health Care Problem or Issue
Learner’s Name
Capella University
Developing a Health Care Perspective
March, 2018

ANALYZE A CURRENT HEALTH CARE PROBLEM OR
ISSUE 2
Patient safety, as discussed in the previous assessment, is an
important element of quality
health care. This assessment will expand upon patient safety
issues that occur when patients are
exposed to inadvertent harm or injury while receiving medical
care. Health care organizations
should maintain and develop a safety culture to prevent patient
safety issues. Patient safety
culture is defined as a system that promotes safety by shared
organizational values of what is
important and beliefs about how things work. It also
encompasses how these values and beliefs
interact with the work unit, organizational structures, and
systems to produce behavioral norms
(Ulrich & Kear, 2014). As such, care should be taken to

improve the infrastructure of health care
organizations. Improving patient safety should be discussed and
addressed by every individual
associated with public health care.
Elements of the Problem/Issue
Research shows that while getting treated at health care
organizations, patients might be
at risk of experiencing the harm or injuries associated with
medical care. The most likely causes
of patient safety issues are preventable adverse events, which
are adverse events attributable to
error. These errors can be classified as diagnostic errors,
contextual errors, and communication
errors (Ulrich & Kear, 2014).
Diagnostic errors take place when health care professionals
provide a wrong or delayed
diagnosis or no diagnosis at all (James, 2013). An example of a
wrong diagnosis is a health care
professional diagnosing a patient with gastric troubles when the
patient is actually experiencing a
heart attack. An example of a delayed diagnosis is a patient not
being notified of an abnormal
chest X-ray, thereby delaying diagnosis of a serious medical

condition. An example of a missed
diagnosis is a patient not being diagnosed with heart failure
despite warning symptoms.
ISSUE 3
Contextual errors occur when health care professionals fail to
consider their patients’
personal or psychological limitations while planning
appropriate care for them. An example is a
health care professional’s failure to recognize that basic follow-
up discharge instructions may not
be understood by patients with cognitive disabilities (James,
2013). It is important for health care
professionals to be aware of their patients’ mental and physical
abilities before they formulate a
plan of care.
Communication errors occur when there is miscommunication or
lack of communication
between health care professionals and patients (James, 2013).
They can cause severe harm to

patients. An example of this is a nurse failing to tell a surgeon
that a patient experienced
abdominal pain and had a drop in red blood cell count after an
operation, resulting in the death of
the patient due to severe internal bleeding. Limited health care
knowledge; language barriers;
and auditory, visual, and speech disabilities could also lead to
communication errors and cause
safety issues.
Analysis
As a medical transcriptionist, it is important for me to be aware
of potential transcription
errors and privacy standards, which affect patient safety. Errors
like these pose dangerous risks;
therefore, it is necessary to have an overall quality evaluation
of the transcribed documents.
Also, I must ensure that serious difficulties in transcription
resulting from poor-quality voice
files are reported immediately to the manager, who will then
convey this to the health care
professionals involved in the process. This will help ensure that
patient safety is not
compromised.

Context for Patient Safety Issues
Comment [A1]: You provided a clear
explanation regarding the problem
investigated. The possible causes were
explored.
Comment [A2]: Which error classification
describes these errors? Add this information to
add continuity.
ISSUE 4
With the advancement of medical technology, health care
processes have become extremely
complex. Health care professionals are required to stay up-to-
date with a lot of new knowledge
and innovations obtained from research. This often overburdens
them as there is a need to apply
the learning from research in their practice. Also, at the
individual level, there is a dearth of well-
balanced continuing education programs, which has resulted in
a lack of attention to patient

safety among health care professionals. At the system level,
organizations fail to deliver
optimum health care as a result of being understaffed, an
inability to provide appropriate
technology, and ineffective execution of patient care transfer
(James, 2013). Overcrowding and
understaffing delays initiation of treatment and puts critically
ill patients at significant risk. All
of these factors contribute to a rise in patient safety issues.
Populations Affected by Patient Safety Issues
Patients with a psychiatric history are also a vulnerable group
of people who face patient
safety issues because their psychiatric records are often
combined with their current symptoms.
Patients with a documented history of psychiatric illness may
avoid seeking health care services
as they feel that their care will be based on their past record of
illnesses and not their present
needs. Therefore, psychotherapists should implement measures
such that their psychiatric data is
concealed from their medical records before it is shared with
the third party, which helps protect
patients’ confidentiality (Shenoy & Appel, 2017).

Considering Options
Patient safety in hospitals can be achieved by creating a culture
of safety that involves
effective communication, correct managerial leadership styles,
and the use of Electronic Health
Records (EHRs).
Comment [A3]: You effectively indicated
which causes were the most likely to create
safety issues.
Comment [A4]: This section was very
informative about special populations, but it
would be of value to also include the general
populations discussed earlier in this paper
(such as public health patients and hospital
patients).
ISSUE 5
Effective communication while passing patient-specific
information from one health care
professional to another is essential in ensuring continuous and
safe patient care. Training the

team could likely improve consistent successful communication
and help prevent errors.
Standardizing critical content that needs to be communicated by
the initial health care
professional ensures safe transfer of care (Farmer, 2016).
It is essential for leadership teams to adopt organizational
strategies that would improve
patient safety and transform their organizations into reliable
systems for enhanced patient
satisfaction. They should set strategic safety goals, which could
include adhering to standards of
health, assessing quality, using patient satisfaction reviews, and
analyzing adverse event reports
to determine improvement in safety issues (Parand, Dopson,
Renz, & Vincent, 2014).
An EHR is another potential solution to prevent patient safety
issues. It is a digital record
of a patient’s medical information that includes history,
physical examination, investigations, and
treatment (Ozair, Jamshed, Sharma, & Aggarwal, 2015). It helps
manage multiple processes in
the complex health care system and prevents errors. EHRs
utilize less storage space compared to
paper documentation and allow an infinite number of records to

be stored. In addition to being
cost-effective and preventing a loss of records, EHRs help
conduct research activities and
provide quick data transfer (Ozair et al., 2015).
Solution
In health care, because transmission of information takes place
among different people
and electronic devices, there is a high likelihood of errors
occurring. For example, transcription
errors (which occur due to poor audio quality or the lack of a
quality evaluation process) can be
prevented by using recording equipment with good sound
quality and by maintaining
proofreading and quality checks. However, integrating
transcription processes with the EHR

ISSUE 6
system helps prevent errors, helps access the required
information faster, and allows health care
professionals to take accurate decisions about patients’ care.
Implementation
An EHR is an important mechanism for improving patient
safety. Its advancement has
made it a viable option to prevent medical errors. However, the
use of EHRs has certain ethical
implications such as security violation, data inaccuracies, lack
of privacy and confidentiality, and

challenges during system implementation. Security violation
takes place when patients’
confidential health information is accessible to others without
their permission. To avoid security
violation, data should not only be password protected but also
encrypted to restrict access to
unauthorized individuals. Firewalls and antivirus software
should be used to protect data (Ozair
et al., 2015).
Though EHRs improve patient safety by reducing medical
errors, data inaccuracies are
increasing. Loss of data during data transfer leads to
inaccuracies that affect decision-making
related to patient care. A problem of concern related to data
inaccuracy is medical identity theft,
which leads to incorrect information being filed into a person’s

medical record, which in turn
leads to insurance fraud and wrong billing (Ozair et al., 2015).
In health care, information that is shared during physician–
patient interactions should be
kept confidential and should be made inaccessible to
unauthorized individuals. Enabling role-
based access controls based on user credentials will restrict
access to the EHR system to
authorized users. The user should also be made aware that he or
she is responsible for any
information that he or she misuses (Ozair et al., 2015).
As EHR is a complex software, there is a high likelihood that
software failure may result
in inaccurate recordings of patients’ data. Therefore, EHR
system implementation may have

ISSUE 7
ethical implications due to the violation of data integrity (Ozair
et al., 2015). EHRs can safeguard
patient confidentiality by using various methods that prevent
security breaches. In addition to
this, creating reminders that ask for a confirmation before
accessing confidential information can
help protect data. A nesting system could be developed, which
would allow, for example, a
health care professional from a specific specialty clinic to
access patient records by signing into
the specialty domain (Shenoy & Appel, 2017). These methods
will enable the safe and efficient

use of EHRs and ensure patient safety.
Conclusion
Patient safety involves preventing the risk of harm or injuries to
patients by establishing a
safety culture and providing high-quality medical care. Health
care organizations must
understand patient safety issues and find solutions for these
issues by designing systems that
prevent errors from occurring. Potential solutions include
effective communication, changes in
leadership style, and the use of EHRs. The ethical implications
of these solutions should be
considered before implementing them in a health care setting. It
is also important that health care
professionals undergo continuous education and effective
training, provide appropriate medical

care, prevent errors, and follow safety practices to improve
clinical outcomes.
Comment [A5]: The concluding paragraph
summarizes the analysis and solutions offered
in this paper.
ISSUE 8
References
Farmer, B. M. (2016). Patient safety in the emergency
department. Emergency Medicine, 48(9),
396–404. Retrieved from https://mdedge.com/emed-
journal/article/113659/trauma/patient-safety-emergency-

department
James, J. T. (2013, September). A new, evidence-based estimate
of patient harms associated with
hospital care. Journal of Patient Safety, 9(3), 122–128.
Retrieved from
https://journals.lww.com/journalpatientsafety/Fulltext/2013/090
00/A_New,_Evidence_ba
sed_Estimate_of_Patient_Harms.2.aspx
Ozair, F. F., Jamshed, N., Sharma, A., & Aggarwal, P. (2015).
Ethical issues in electronic health
records: A general overview. Perspectives in Clinical Research,
6(2), 73–76.
http://dx.doi.org/10.4103/2229-3485.153997
Parand, A., Dopson, S., Renz, A., & Vincent, C. (2014). The
role of hospital managers in quality
and patient safety: A systematic review. BMJ Open, 4(9).

http://dx.doi.org/
10.1136/bmjopen-2014-005055
Shenoy, A., & Appel, J. M. (2017, April). Safeguarding
confidentiality in electronic health
records. Cambridge Quarterly of Healthcare Ethics, 26(2), 337–
341. Retrieved from
https://search-proquest-
com.library.capella.edu/docview/1882434628?pq-
origsite=summon&https://library.capella.edu/login?url=accounti
d=27965
Ulrich, B., & Kear, T. (2014). Patient safety and patient safety
culture: Foundations of excellent
health care delivery. Nephrology Nursing Journal, 41(5), 447–
456, 505. Retrieved from
com.library.capella.edu/docview/1617932572/fulltextPDF/1486

CC30B3624B3CPQ/1?ac
countid=27965
Comment [A6]: You provided a well-
researched paper. Your paper is enhanced by
the use of recently published academic peer
review journal articles.
CC30B3624B3CPQ/1?accountid=27965

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