Healthcare Plan
A woman in the mid 60 is diagnosed with heartbeat failure since her heart could not beat on its own. She was admitted to Amass Emergency Hospital Department after being taken there unconscious. However, reports claim that the woman denied all allegations that she had taken something with a high concentration speculated by the doctors who examined her conditions and ascertained that she was to have cardiology treatment. Therefore, this paper will discuss the woman’s medical treatment program and the available insurance medical coverage that would help the woman access the American Medical Treatment facilities in response to her insurance coverage.
The Patient
Demographic Background
The Patient is a mid-60’s, Vietnamese woman; she has 12 children. All her children were brought to the USA over the past 50 years. She has no education and cannot read or write any language, but speaks Vietnamese Fluently. A very religious person she prays and listens to Vietnamese Priests 20 Hours a day. All of her children own Nail Salon except for two who were brought to the USA when they were less than 2 Years old. Those two are highly educated one with a Duel Masters and Decorates by the age of 24. Although all the children make an income around 100,000 a year, 80% undocumented. “Refugees are allowed to stay in the United States due to fear of political reprisal if returned to the country of origin” (Duston- Stamps 2016, pg. 69).
Support System
The patient lives in Worcester, MA and lives with one of her eight daughters in a house owned by her daughter as her husband of 60 years passed away from stage-4 lung cancer. The patient has 23 grandchildren all US born. Twenty-two of the grandchildren are on public assistance, and eight of her children enjoy a complete public assistance package that equals a lower-middle-class standard of living, in addition to their 80,000-dollar cash incomes that are undocumented.
Access to Basic Resources
The patient has amazing access to medical care through a refugee program providing her access to the best hospitals and doctors, food, heat, and housing stipends, among other benefits. However, after 50 + years in the USA, she can speak 10 English words, and not one person in the entire family knows how to engage in the health system or an assistance program. The patient was diagnosed with heart failure, severe bilateral edema, fractured disks in her back, severe body wide out, chronic A-fib, high cholesterol, and found unhealthy, consistent with a lack of care.
Patient’s Illness and Health Behaviors
Illness
The patient is a mid-60’s woman admitted to Amass Emergency Department, unconscious and non-responsive. She was brought back to consciousness, having been externally paced. She denied she had taken anything and was a mystery to the doctors who had cardiology on their way to deal with the heart inability to beat on its own. Thus, it is crucial to explore the patient’s culture, history, support system, access to care including the cultural health behaviors that caused her condition, and the process that was implemented to manage the health issues.
Exacerbating Health Behaviors
The patient has a history of self-medicating and practicing alternative medicine, including Vietnamese medicine with her family, stating that she was a hypochondriac. Her Family reports that she takes half a bottle of Nyquil a day and takes more than a dozen supplements only available at underground Vietnamese Pharmacies. She has never told anyone that she overdosed on someone else’s medication. Traditional health practices and beliefs that are deeply rooted in the cultures of non-Americans has been a major factor leading underutilization of health services from the West (Jenkins, 1996). For example, Jenkins (1996) notes that such practices and beliefs have been barriers to improved medical care among the Vietnamese.
Preventive Health Behaviors
The patient has no intention to stray from her alternative beliefs of Medicine and has access to lethal doses of medications both alternative and not from any of the dozens of underground Pharmacies, which are common to her culture. Therefore, the doctors would recommend the patient staying at the hospital for a while for her to stay away from her traditional medication. Leaving the woman to stay with her daughters would lead to stroke, COPD, diabetes, and chronic heart failure (National Institutes of Health, 2016).
Treatment Plan
Care Plan Overview
The Vietnamese woman would receive treatment from the hospital for her various conditions, including heart failure, bilateral edema, which she probably attained through self-medication procedures with traditional medicine, and gout. However, heart failure was her severe symptom thus; doctors recommended a change in lifestyle that included quitting smoking. Similarly, the doctors would prescribe the use of ACE inhibitors that helps in lowering blood pressure, straining of the heart, and reduces heart attacks. Her heart condition was not worse than expected since she realized the problem at an early stage. The Vietnamese woman was lucky to when she was taken to the emergency center since her condition could have been worse if she did not have an emergency access to a medical facility. Therefore, the doctors would propose a full restorative care that will include daily checkups that would determine her recovery process (Behavioral Health Network, 2016). Similarly, the doctors have proposed gout treatment that includes reducing severe pains from an inflammatory itching on the body. Therefore, she would have to stay in the hospital facility to receive ample care. The doctors in the hospital will recommend a checkup on her diet since she suffers from high cholesterol and a chronic A-fib. They should refer her to a nutritionist to provide her with the best nutrition plan based on her conditions.
Continuing Care and Support
The nature and extent of her sickness will determine whether doctors should consider a discharge or a referral to another facility. Therefore, heart failure condition and smoking habits will not allow medical practitioners to release her to avoid worsening her condition. The doctors in the hospital should refer the Vietnamese woman to a skilled nursing facility where specialized physicians can check the process of her recovery in preventing another heart failure as well as help her quit or reduce smoking. The doctor assigned with the responsibility of her health recommends frequent checkups and keeping her away from any possible substance apart from the prescribed medication (Behavioral Health Network, 2016). For instance, the family of the woman has recorded a statement arguing that she used to take traditional medicine that hindered her recovery process. Therefore, a full custody is better for her health as well as ensuring her conditions do not worsen.
Cognitive and Physical Rehabilitation
Doctors and physicians inside the referral facility should incorporate frequent checkups in the development of leg edema that is caused by the heart failure. For instance, her doctor can recommend physical exercises in an effort of preventing blood clotting in the body muscles that can be brought by thrombosis and lack of venous in the veins (National Institutes of Health, 2016). The doctors might as well recommend implanting a pacemaker that would help in thinning the blood probably from the causes of A-fib condition. Therefore, these procedures might take a while before the woman recovers from the heart condition. The doctors can also recommend the best hospital that can handle coronary heart problems in Boston. Therefore, the best from the list emerged to be Massachusetts General Hospital in Boston since the first emergency destination was from the same town (Massachusetts General Hospital, 2016). These measures would ensure an improvement to the health of the Vietnamese woman in her recovery.
Care Plan Caveat
The doctors can also recommend the woman to take another transfer to a facility that offers physical and mental therapy to individuals with heart problems. Therefore, the woman will receive substantial care in the facility that includes exercises that help in the movement of the body. Unfortunately, the insurance cover does not have a full coverage of her medical attention. The woman will need to cater for other expenses during her stay in the medical facility. Since her health would not be fully retained, the insurance only covers the first twenty days of her stay in the hospital. The subsequent days would be chargeable at a high rate of £144.99 per day. The cost of treatment past the first twenty days would be very high considering that the woman is from a poor background and her two daughters might not afford the expenses. Therefore, the care plan suggested would face challenges in the effort of minimizing the risks of her heart conditions. The woman is supposed to be taken home or to a cheaper facility they could afford.
Health Insurance Coverage
The woman has an insurance cover offered by the government on a platform of Indian Health Service. The program helps register Indian Americans and other Alaska Natives living in the U.S to acquire desirable medical attention. However, the program only covers the refugees from other countries in an effort of preventing political reprisal (Pellegrini, 2016c). Therefore, the program offers full support in healthcare facilities to the woman who has access to better health facilities as well as treatment. Similarly, the woman is covered by the Mass-health insurance program that helps individuals with habits of smoking in Medicaid insurance program. As a senior woman, she has the privilege to have full support from the government (Pellegrini, 2016c). The program caters for the full amount entitled for the refugees when in need of medical attention. Similarly, the Vietnamese woman is enrolled to Medicaid program where she pays through employment procedure under her daughters’ salaries. The program collects funds from individuals as well every state in U.S hence; utilizing the taxes paid by the citizens. Therefore, she will not have complications in achieving her medical attention since the government and finance from her daughter would cater for almost everything.
Care Plan Implications
The woman used emergency transport when she was taken to the hospital. The Medicaid insurance coverage catered for the transportation costs. Therefore, the woman was not supposed to pay a full amount of the emergency transportation fee. Similarly, the services she was offered at the hospital included the treatment with ACE inhibitors that incorporated necessities to patients (Stamps-Duston, 2016). The insurance covered the whole amount of the bills used in the hospital since her insurance included a system of tax payment where they were paid by her daughters. Therefore, the expenses of the emergency transportation and the stay at the hospital facility did not have complications. The problem came when the woman was to be taken to a skilled nursing facility that would help her fight her addiction to smoking as well as preventing the woman from taking traditional drugs.
Insurance Caveats
Insurance does not define the nature of services one should get from a particular facility. However, the nature of insurance cover found in Medicaid and that covers the Vietnamese woman failed to cater for her full expenses in the Skilled nursing facility. The doctors had suggested the importance of the woman attending the SNF, but her insurance would not cover the amount hence; leading to non-treatment of the whole heart problems. Therefore, the SNF and the government ensure that patients stay in the facilities until they get better but pay for the costs later. The SNF must provide care and medication to a patient regardless of their financial distress (Pellegrini, 2016c). The strategies used by Medicaid Insurance and the Indian Health Service insurance affects the provision of proper medical care to patients in a given area.
Performance of U.S Healthcare System
The form of health service rendered to the refugees and other tribes in U.S is known as Indian Health Service that incorporates those people that do not have access to insurance cover, and those that have a zero earning rates (Pellegrini, 2016a; Pellegrini, 2016b). The government provides health services and covers to the refugees and the immigrants as well as the seniors (Pellegrini, 2016c). The program receives funds from the government that helps the Indian people and other patients from all over the world in the U.S. attain an affordable medical treatment (Pellegrini, 2016b). Therefore, the Vietnamese woman will have a full support of the program. Similarly, the Medicare program would also help the Vietnamese woman in attaining the desired medical program. The U.S has a program that helps the aged in getting the medical attention they require through the proposed medical development (Stamps-Duston, 2016). Therefore, she will not have difficulties in paying the bills in the hospital and the skilled nursing facility.
Conclusion
The condition of the Vietnamese woman grew worse given her smoking habits and use of traditional medicine that reduced the effectiveness of her treatment plan. With traditional beliefs acting as barriers to access to proper care, managing her situation requires a careful approach to avoid worsening the situation. Additionally, with no cover and a large family to look after, she has challenges paying her medical bills. However, the U.S health care system favors the incorporation of health insurance that covers non-citizens who have the privilege to enjoy the services through a system of Refugee Medical System. The health of the Vietnamese woman is affected by other factors such as social, political, and economic factors that had both positive and negative effects. Thus, her case presents a challenge to the U.S. Department of Health and other agencies to formulate policies to ensure that the health of refugees and those seeking asylum from any country remains a priority for most health care systems. Additionally, health education to end misconception on the use of treatment from the West among communities that have strong beliefs on the efficacy of traditional medicine over the latter is crucial to save the lives of more people like the Vietnamese woman. Thus, a cultural diversity and input from diverse groups of people will go a long way in ensuring the success of such programs.
References
Behavioral Health Network. (2016). Hope center. Retrieved, from http://bhninc.org/content/hope-center
Jenkins, C. N., Le, T., McPhee, S. J., Stewart, S., & Ha, N. T. (1996). Health care access andpreventive care among Vietnamese immigrants: do traditional beliefs and practices pose barriers? Social science & medicine,43(7), 1049-1056.
Massachusetts General Hospital. (2016). Study finds following a healthy lifestyle can greatly reduce genetic heart attack risk. Retrieved, from http://www.massgeneral.org/about/pressrelease.aspx?id=2012
National Institutes of Health. (2016). What is stroke? Retrieved, from http://www.nhlbi.nih.gov/health/healthtopics/topics/stroke/ (National Institutes of Health, 2016)
Pellegrini, LC. (2016a). Economics, politics, and government. Retrieved, from https://uma.umassonline.net
Pellegrini, LC. (2016b). Future of the healthcare system: Health disparities. Retrieved, from https://uma.umassonline.net
Pellegrini, LC. (2016c). Health insurance: Fundamentals of health insurance coverage in the US. Retrieved, from https://uma.umassonline.net
Stamps-Duston, P. (2016). Analyzing form, function, and financing of the U.S health care system. Boca Raton, FL: CRC Taylor and Francis Group.
