NHS FPX 6008 Assessment 1
[Student Name]
Capella University
Professor’s Name
August 2025
NHS FPX 6NHS FPX 6008 Assessment 1: Identifying a Local Healthcare Economic Issue
Serving the people of Bedford and surrounding areas with quality medical care of the highest caliber has been the number one priority of UPMC Bedford ever since it was established. The new prices of specific insulin medications have raised concerns regarding the medical organization struggle to ensure that the community is capable of acquiring all discharge prescriptions. Scialli et al. (2021) claim that without taking their medications as prescribed, patients are also at risk of developing secondary health issues and readmission to the hospital. It will be assessed in terms of the weaknesses that contribute to the worsening of this economic issue, and the direct and adverse outcomes of increasing insulin prices on populations, hospitals, and patients as highlighted in NHS FPX 6008 Assessment 1.
Slide 2:
Home insulin funding resulted in 38 patients, who were categorized as 30-day readmissions based on hospital readmission reviews. UPMC Bedford is a rural community hospital that provides health care to about 50,000 residents, 11.6 percent of whom live in poverty (U.S Census Bureau, 2020). In 2023, more than 68% of the patients admitted to the 422 beds of UPMC Bedford were discharged on insulin to manage their type 1 or type 2 diabetes (UPMC, 2023). Insulin can be used in the treatment of hyperglycemia in patients with either type 1 or type 2 diabetes mellitus. Re-hospitalization, secondary health complications and mortality are more likely to occur when patients lack the means to purchase insulin or other prescriptions as noted in NHS FPX 6008 Assessment 1. Reduction of 30-day readmission should be targeted in hospitals; especially among patients with diabetes who comprise approximately 25% of all hospitalizations annually. Moreover, because of their financial insecurity, individuals with socioeconomic determinants are more likely to be hospitalized and hospitalized within 30 days (Sterling et al., 2021).
Rational for Healthcare Economic Issues
It is either type 1 or type 2, but diabetes is a life-changing disease that requires medicine and treatment daily. The medical practitioner can recommend a combination of lifestyle modifications, oral therapy, multiple injections, or both, but these decisions are often influenced by healthcare economic
issues that affect access and affordability. Primary and secondary health outcomes that may develop as a result of the illness remaining untreated by both the patient and the healthcare provider include cardiovascular disease, kidney failure, peripheral neuropathy, vision loss, and the potentially fatal diabetic ketoacidosis (Abdulmalek and Balbaa, 2019). The price of insulin in the US is the highest among 33 other countries with analogous high-income economies. The average price of insulin in the US was 8.1 times above the average price in Chile (3.9 times), Turkey (27.7 times) and the rest of the world (3.9 times), in 2018 (Sterling et al., 2021).
UPMC Bedford can observe this dynamic state of affairs in the medical-surgical staffing proportions. The medical-surgery inpatient staffing ratio shifted to one registered nurse to every five patients prior to the pandemic to one registered nurse to every eight patients after the outbreak as highlighted in NHS FPX 6008 Assessment 1. UPMC Bedford belongs to a bigger health care system where policies and guidelines, including the nurse-to-patient ratio, must vary in accordance with the number of patients in the hospital and the number of medical professionals available. The rates of U.S. hospitalization in the COVID-19 pandemic depended on the time of infection. Discharge phone calls have already commenced at UPMC Bedford, and the majority of questions are related to discharge medications, including their cost, availability, acquisition status, and other related issues, which reflect key issues in health economics. These figures show that the mortality per patient in the hospital is rising by 47 percent, a critical situation when we are dealing with chronic patients like diabetes mellitus as highlighted in NHS FPX 6008 Assessment 1 (Al-Amin et al., 2022), hence this measure is needed to reduce the number of insulin-dependent patients who are likely to be hospitalized because of financial factors.
Direct and Negative Impact
People with diabetes failing to take their insulin as prescribed or failing to access it when they need it hit communities, healthcare systems and people hard as identified in NHS FPX 6008 Assessment 1. To identify the cause of a patient readmission and the potential measures that could be taken to avoid the readmission, a stakeholder inquiry should be performed when a patient returns to hospital within 30 days.
To explore the readmission of the patient and how to assist the patient, investigating the prescription and discharge information, observing whether they received and taken their prescription, and further exploring the cause of their readmission is essential for effective health issues identification. Since the patient requires medical care and attention of the staff at the hospital, readmissions impact the institution negatively. There have been significant fluctuations in the hospital inpatient census during periods of high occupancy. Published data states that nearly three out of every four 30-day readmissions would not have happened in case the insurance company had been more concerned with such issues as clarifying the discharge instructions, improving patient disposition, additional resources in the community, or increased investments (Jatinder Lachar et al., 2023). In the event that the patient reveals that they are not able to afford their medication, case management will be requested to seek avenues of assisting them with the payment. It requires a case management system to react to the socioeconomic implication of 11% poverty rate in Bedford (County Socioeconomic Profile, 2022).
Healthcare Gaps
A pilot study was carried out by case managers (CMs) of a tertiary academic medical center and involved all patients who attended the daily multi-disciplinary discharge rounds (MDRs) to discuss their post-discharge resource needs. To solve this medical problem, it is critical that case managers and bedside nurses openly discuss the capability of patients to afford insulin at home, as this dialogue is a vital step in health problem identification. To the ill and their families, such discussions may be unbearably uncomfortable. Still, they are required and have to be filled before the release. This team will ensure that the patient goes home with everything that was prescribed to them (including recovery and maintenance medications, primary care and specialist follow-up appointments, home health services, etc.) (Enabnit, 2023).
In the case of inpatients such as those who cannot get their home prescriptions filled due to various reasons such as transportation and money, a program known as Meds to Bed has been established at a national level. This service is only one of the solutions to the problem of patients who need to be
transported to the pharmacy prior to discharge to receive their home medications as well as new medications such as insulin.
This program has been introduced in the last nine months at the UPMC Bedford to patients with social and economic hardships. The financial component of the initiative involves case management, which will assist patients in accessing all of the financial resources necessary to obtain their medicine. In the meantime, an inpatient pharmacy is available to help patients with any questions about medications (Dopp et al., 2020). The shift towards patient-centered care (PCC) and evidence-based medicine (EBM) or evidence-based practice (EBP) also represents another shift in healthcare that occurred over the past decade (Engle et al., 2021).
Conclusion
This has seriously impacted the health of this population as a result of the insulin cost change that has now been acknowledged by the UPMC Bedford. To find out the causes of this financial crisis, the analysis in NHS FPX 6008 Assessment 1 examined the impact that has been suffered by patients, communities and hospitals with the rising cost of insulin. When a patient gets secondary health issues due to his/her diabetes or gets a new diagnosis, he/she needs quality treatment and should take insulin and medications according to the prescriptions.
References
County Socio-economic Profile. (2022). https://agwebv01.ag.utk.edu/agecon-tableau/Bedford.pdf
Dhaliwal, J. S., & Dang, A. K. (2024). Reducing hospital readmissions. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK606114/
Dopp, A. R., Narcisse, M.-R., Mundey, P., Silovsky, J. F., Smith, A. B., Mandell, D., Funderburk, B. W., Powell, B. J., Schmidt, S., Edwards, D., Luke, D., & Mendel, P. (2020). A scoping review of strategies for financing the implementation of evidence-based practices in behavioral health systems: State of the literature and future directions. Implementation Research and Practice, 1(July-September), 263348952093998. https://doi.org/10.1177/2633489520939980
Enabnit, A. (2023). Discharge Planning: Ensuring a Smooth Transition from Hospital to Home – DoveMed. DoveMed. https://www.dovemed.com/health-topics/focused-health-topics/discharge- planning-ensuring-smooth-transition-hospital-home
Engle, R. L., Mohr, D. C., Holmes, S. K., Seibert, M. N., Afable, M., Leyson, J., & Meterko, M. (2021). Evidence-based Practice and patient-centered care: Doing Both Well. Health Care Management Review, 46(3), 174–184. https://doi.org/10.1097/HMR.0000000000000254
Herman, W. H., & Kuo, S. (2021). 100 years of insulin: Why is insulin so expensive and what can be done to control its cost? Endocrinology and Metabolism Clinics of North America, 50(3), e21– e34. https://doi.org/10.1016/j.ecl.2021.09.001
Jatinder Lachar, Avila, C. J., & Qayyum, R. (2023). The Long-term Effect of Financial Penalties on 30- day Hospital Readmission Rates. https://doi.org/10.1016/j.jcjq.2023.06.001
Scialli, A. R., Saavedra, K., & Fugh-Berman, A. (2021). The benefits and risks of adherence to medical therapy. The Journal of Scientific Practice and Integrity, 3(1). https://doi.org/10.35122/001c.21386
Sterling, M. R., Ringel, J. B., Pinheiro, L. C., Safford, M. M., Levitan, E. B., Phillips, E., Brown, T. M., Nguyen, O. K., & Goyal, P. (2021). Social determinants of health and 30-day readmissions among adults hospitalized for heart failure in the REGARDS Study. Circulation: Heart Failure, 15(1). https://doi.org/10.1161/circheartfailure.121.008409
