Introduction
Though the population of the US has at all times encompassed an affluent blend of persons having dissimilar ethnic and cultural settings, it is presently turning out to be more dynamic (Derose, Escarce, & Lurie, 2007).
Some of the patient populations in the US include immigrant, pediatric, geriatric, emergency, and psychiatric. As the healthcare administrator, I will seek to educate my staff on the regulations and mechanics of satisfying the healthcare demands of a diverse patient population. To enhance the provision of care that tackles the demands of the diverse population properly, it is significant to boost the cultural capability of medical delivery systems and health professionals and establish the best means of offering healthcare while implementing the required improvements.
Patient Populations
Immigrant patients are individuals from a group of people who do not have American citizenship at birth. The population encompasses legitimate permanent inhabitants, naturalized citizens, individuals on short-term visas, the unauthorized, and refugees (Derose et al., 2007).
The immigrant population in the US rose tremendously from 1970 to 2000. In this regard, the fraction of immigrants in the US, 13% in 2014, is progressively increasing. By 2014, over 41 million immigrants resided in the United States, beyond fourfold the situation in 1970. On the contrary, people born in the US have only increased by 1.5 times the number in 1970. This indicates that the increase in the immigrant population has resulted in 30% of the American population growth from 2000.
Pediatric patients encompass babies, children, and teenagers whose age scope normally varies from birth to 18 years (until twenty-one years of age in America). On the other hand, geriatric patients represent aged individuals who have impaired overall ability (Lee, Slack, Martin, Ehrman, & Chisholm‐Burns, 2013). This patient population does not have an age limit, but the patients are often over seventy-five years of age and suffer chronic diseases and physical weakness, in addition to cognitive impairment. Moreover, the aged people with frailty usually suffer gait problems and frequent falls, particularly because of postural hypotension, balance difficulties, polypharmacy (beyond three prescription medicines), and administration of sedative-hypnotic drugs.
Psychiatric patients are the people having mental health problems such as anxiety and bipolar disorders, depression, and schizophrenia to mention a few. Many people are convinced that mental health problems are uncommon and can hardly affect them. However, the truth is that mental health problems are common and prevalent. It is approximated that 55 million US residents suffer from mental problems every year (Corrigan, Druss, & Perlick, 2014).
Mental health disorders are usually attributed to extreme stress attributable to a given occurrence or sequence of happenings. The socioeconomic position has been greatly associated with mental health disorders since the extremely poor, homeless, incarcerated, or drug abusers have a high chance of developing mental problems. Similar to the case of other diseases such as cancer, mental disorders have physical, psychological, and emotional impacts. With effective care, counseling, and treatment, people with mental health disorders recuperate successfully.
Emergency patients are the people in need of acute care who have to be treated as soon as possible following their arrival in a health facility, either by an ambulance or other means. Most of the emergency departments (critical care units) in the United States are extremely busy. In 2010, there were about 129 million Emergency Department encounters in health facilities around America. Emergency patients can be of any age from newborn to the elderly (Tarraf, Vega, & González, 2014).
Nearly every emergency patient is treated and released (83%) although a few are hospitalized for inpatient care (about 17%). Attributable to the impromptu nature of the requirement of care by the emergency patients, critical care units have to offer preliminary care for a broad range of injuries and sicknesses, most of which could be life-threatening and demand instant attention.
Health Policies
Though Medicaid earlier covered immigrants, welfare transformation policies, for instance, Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), resulted in stringent situations for eligibility. Such policies mainly switched accountability for the medical care of the immigrants to state and local governments from the federal government. In this regard, the impact of health policies on immigrants differs across states.
It is evident that stipulations of PRWORA bar immigrants from enjoying federal benefits such as Children’s Health Insurance Program (CHIP) if they have not obtained permanent legal citizenship for not less than five years (apart from situations of emergency). The exclusion of immigrants from Medicaid coverage, in the course of their initial years of residing in America, signifies that many of them (in fact, nearly half of them) are uninsured, irrespective of being employed or having severe health concerns.
The number of uninsured immigrants is threefold greater than that of Native Americans (Derose et al., 2007). Attributable to the lack of insurance, immigrants in the US experience serious hindrances to quality health care and have to pay more from their pockets every time they require clinical care. Over and above the medical and humanitarian issues linked to poor health access, immigrants have a decreased likelihood of retaining productive employment, especially because most of them operate in physically strenuous occupations or workplaces that have a high possibility of occupational injury.
Pediatric patients who may not afford to pay for quality care have significantly benefited from CHIP, Medicaid, and numerous protections and stipulations of the Patient Protection and Affordable Care Act. In this regard, the level of uninsured pediatric patients from poor backgrounds has reduced by 70% from 1980 to 2014 (Gidengil et al., 2014). In an effort of gaining from extended insurance coverage, pediatric patients under CHIP or Medicaid have a high probability of accessing preventive care when judged against uninsured children.
CHIP has led to a 10% annual augment in the coverage of pediatric patients who have chronic conditions and a 6% reduction of uninsured teenagers and children in the entire populace. In 2010, CHIP policies broadened access to pediatric care through initiating the coverage of mental and dental care, as well as surgical operations and drug abuse prevention and treatment for every eligible and underprivileged child.
Medicare, a federal government policy, offers medical insurance coverage for geriatric patients, 65 years old and above, people with disabilities, and all patients suffering terminal renal sicknesses (Lee et al., 2013). Moreover, emergency patients are also covered under Medicare everywhere in America. The patients are required to pay a copayment for the care, which is deemed outpatient clinical care. Medicare covers all the emergence of care costs apart from the patient’s copayment. Nevertheless, the copayment is waived in a situation where a patient gets hospitalized for a similar illness in no more than three days after the previous emergency room visit.
The federal government plays a crucial role in financing the treatment of mental health disorders. Over and above financing psychiatric patients covered under Veterans Affairs and Medicare, the federal government backs CHIP and Medicaid. Although these policies do not address mental health entirely, Medicaid acts as the biggest financier of psychiatric care in the US, which ensures quality care. The federal government as well offers Mental Health Block Grants (MHBG) that back the effective provision of mental health care within the society. Mental Health America backs the continued task of the government in financing services and pushing for expanded and sustained financing for psychiatric care (Corrigan et al., 2014).
Issues
Access to and benefit of medical care relies partly on the degree of the immigrant’s acculturation. Language problems may hinder immigrants from obtaining care. For instance, language proficiencies influence one’s chance of getting an employment opportunity. Devoid of sufficient extent of English skills, immigrants are limited to some jobs, usually, the ones that have a low possibility of offering job-anchored insurance (Derose et al., 2007).
There is also the atmosphere of fear and mistrust that bars immigrants, particularly the ones with no documentation, from seeking medical coverage. This emanates mainly from the notion of likely deportation or ineligibility for residency.
Though the Immigration and Naturalization Service has affirmed that obtaining CHIP and Medicaid (save for continuing care) cannot endanger citizenship, most immigrants are not yet aware and think otherwise. Such misconception of health policies might be subsequently compounded with poor knowledge concerning the available medical services. Obstructions might arise from the cultural beliefs of the immigrants. For instance, immigrants from Southeast Asia tend not to seek medical care attributable to their cultural beliefs that illnesses and pain are inevitable in life and, when they occur, one should endure them without help from hospitals.
Almost 50% of pediatric patients are uninsured despite their eligibility for CHIP and Medicaid since their family members do not know it (Gidengil et al., 2014). Insufficient or unavailable medical information, for instance, concerning immunization, acts as a hindrance to effective pediatric care. Moreover, in most cases, children are accompanied to the health facility by housemaids or foster parents who have inadequate knowledge of their present medical requirements. Personnel in pediatric care may also be hindered by insufficient resources as Medicaid, the fundamental insurance coverage for children might restrict some medical services.
Effective care by personnel in the geriatric unit could be hindered by the negative attitude of the elderly. Most of them consider themselves unhelpful as they are approaching death and make insufficient or no effort of remaining active and healthy. Another hindrance may be the risk of falls, which results in most patients demanding emergency care. Furthermore, the fact that most of the geriatric patients are poor may hinder effective attention by health professionals when they fail to afford such things as the required medication, especially if they are not receiving support from their families.
Since the emergency department is the only unit allowed by federal regulations to offer care irrespective of the patients’ capacity to pay, some patients who do not need urgent care may feign their condition to avoid payment. Also, some emergency patients may not be accompanied by people who are well aware of their condition, which may make it difficult for health professionals to establish the needed care successfully or quickly. Crowding in emergency departments may result in stress and burnout among health professionals hence affecting the quality of care negatively (Tarraf et al., 2014).
The stigma and preconception regarding mental health concerns may make it exceedingly hard for people experiencing such things as anxiety, depression, and other psychological problems to admit it, leave alone going for treatment. Such patients only seek care when their condition has worsened thus giving the health professionals a more difficult time than when care is sought early. Cultural beliefs amid some psychiatric patients may also hinder their treatment.
For instance, African Americans consider seeking mental health treatment expressions of weakness and loss of faith. Certainly, many African Americans do not survive mental health disorders, and their beliefs are uncalled for and selfish. The most critical hindrance to effective treatment of psychiatric problems is poverty. Individuals who have a shortage of resources usually have a hard time obtaining or adhering to the appointments by mental health professionals (Corrigan et al., 2014).
Resources
Since English proficiency is vital to communicating with health professionals successfully, one of the resources that will be provided to the staff is translators who will ensure that communication between caregivers and such patients as illiterate or semi-illiterate immigrants occurs smoothly for enhanced quality of care. Without translators, the insufficiency of understanding could result in misconception in the required health care (Derose et al., 2007). Mental health professionals will also be provided to establish quality enhancement approaches through improving awareness and offering educational materials for psychiatric patients and their family members. Moreover, counselors will be offered to provide counseling that is essential to overcome cultural beliefs and support to triumph over hindrances to care.
Conclusion
Pediatric, immigrant, geriatric, emergency, and psychiatric patients are examples of patient populations in the US. Being a healthcare administrator, sought to enlighten my staff on the regulations and technicalities required to satisfy the healthcare demands. The healthcare needs of the diverse patient population may be complicated partly by the challenges experienced in accessing and utilizing the offered care successfully thus interventions should be implemented to address the occurring problems.
References
Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014). The impact of mental illness stigma on seeking and participating in mental health care. Psychological Science in the Public Interest, 15(2), 37-70.
Derose, K. P., Escarce, J. J., & Lurie, N. (2007). Immigrants and health care: Sources of vulnerability. Health Affairs, 26(5), 1258-1268.
Gidengil, C., Mangione-Smith, R., Bailey, L. C., Cawthon, M. L., McGlynn, E. A., Nakamura, M. M., & Schneider, E. C. (2014). Using Medicaid and CHIP claims data to support pediatric quality measurement: Lessons from 3 centers of excellence in measure development. Academic Pediatrics, 14(5), S76-S81.
Lee, J. K., Slack, M. K., Martin, J., Ehrman, C., & Chisholm‐Burns, M. (2013). Geriatric patient care by US pharmacists in healthcare teams: Systematic review and meta‐analyses. Journal of the American Geriatrics Society, 61(7), 1119-1127.
Tarraf, W., Vega, W., & González, H. M. (2014). Emergency department services use among immigrant and non-immigrant groups in the United States. Journal of Immigrant and Minority Health, 16(4), 595-606.