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I also need 250 words cross post to this posting… Mrs. Jones demonstrates a gr
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I also need 250 words cross post to this posting…
Mrs. Jones demonstrates a great need for healthcare as evidenced by her multitude of comorbidities that require regular office visits with multiple providers, routine testing, and daily medications. Mrs. Jones utilizes a preferred provider organization (PPO) that she obtained through her employer for her healthcare needs. PPO enrollees are generally covered when they see any physician in a typically broader physician set with or without a PCP referral. PPO enrollees still have incentives, in the form of substantially lower patient cost-sharing, to use a preferred set of physicians under contract with the insurer (Geissler, 2021). Since Mrs. Jones has a PPO, she has access to a variety of providers within a network as well as the flexibility of using providers in and out of her network without the need of referrals. This will be beneficial as Mrs. Jones will need care from multiple specialties.
The five social determinants of health include income, education, environment, lifestyle, and genetics. These elements in an individual’s environment impact their health condition (Henderson, 2018). Mrs. Jones earns an annual salary of $80,000 which places her in a middle-class socioeconomic status. Mrs. Jones theoretically should have the financial means to afford copays, prescriptions, and procedures. Mrs. Jones is married and lives with her husband in a suburb of Chicago which leads me to believe she has adequate access the basic necessities of life. Mrs. Jones holds a master’s degree in business administration which demonstrates her ability to comprehend complex theories. Mrs. Jones has a history of smoking which could be a contributing factor to her asthma and places her at an increased risk for cancer thus requiring closer yearly monitoring, screening and wellness checks. Lastly, Mrs. Jones does not have a routine exercise routine which could put her at an increased risk for obesity and cardiovascular disease.
Mrs. Jones is 55 years old which places her in Generation X (1965-1980). This generation followed the baby boomer generation and is now helping care for this generation. Helping care for the aging population as well as their own family and working full time can place a strain on women like Mrs. Jones which could increase the risk for psychological issues such as depression due to lack of self-care. Mental health would be a large concern and place a demand for mental health providers in our healthcare system.
The quality-adjusted life year (QALY) measures the effectiveness of “Reaching for Better Health” by providing an initial score based off the patient’s current health status when starting the program and then again, a year later to compare the two values to determine disease burden. The value would assess the value of medical intervention provided to measure quality and quantity of life (Henderson, 2018).
Geissler, K.H., Lubin, B. & Ericson, K.M.M. The association of insurance plan characteristics with physician patient-sharing network structure. Int J Health Econ Manag. 21, 189–201 (2021). https://doi.org/10.1007/s10754-021-09296-4
(Links to an external site.)
Henderson, J. W. (2018). Health economics and policy (7th ed.). Cengage Learning US.