Healthcare continuum and coordination

Excellent Healthcare Delivery: Ensuring Continuity of Care

An excellent healthcare delivery system ensures all patients have access to high-quality, affordable, and well-coordinated health services, maintaining the continuity of care. Patients’ experiences vary based on their health issues and the proximity of healthcare facilities. When seeking healthcare, affordability and quality are paramount considerations for patients. The financing of healthcare services and the quality of care significantly impact patient experiences.

Patient Description

Consider a hypothetical 65-year-old woman living in Texas, diagnosed with stage 4 esophageal cancer. This advanced cancer has metastasized to other areas. Esophageal cancer originates in the esophagus, the tube responsible for carrying liquids and solids from the throat to the stomach. The patient’s cancer is located in the lower esophagus, indicating the most severe form of the disease.

Continuum of Care

Initially, the patient experienced difficulty swallowing and chest pain. With a stage 4 esophageal cancer diagnosis, treatment aims to control cancer and alleviate symptoms, as surgery is not a viable option. The patient requires chemotherapy from Texas Oncology to improve her quality of life and extend survival. Additional services include thermal laser coagulation to temporarily relieve dysphagia and proton therapy from the Texas Center for Proton Therapy. Proton therapy delivers high-energy proton beams directly to the tumor with precision, minimizing damage to surrounding healthy tissues. Supportive care is essential to manage pain and side effects as the patient approaches end-of-life.

Payment Challenges

The high cost of cancer treatment can significantly impact a patient’s focus on recovery, causing distress and financial strain for patients and their families. Even with health insurance, managing these costs is challenging. The inability to afford treatment can lead to patients discontinuing therapy, worsening their condition and increasing pain. Financial concerns can overshadow recovery efforts, emphasizing the need for affordable healthcare solutions.

Institute of Medicine (IOM) Aims

The Institute of Medicine identifies six aims for healthcare: safe, effective, timely, efficient, patient-centered, and equitable care. The example illustrates positive attributes related to timely and patient-centered care. Timely care reduces waits and delays, enhancing the overall patient experience. Texas Oncology ensures timely care by maintaining adequate resources and equipment, thereby eliminating long waits and improving efficiency.

Patient-centered care involves respecting and responding to individual patient preferences, values, and needs, guiding clinical decisions accordingly. Texas Oncology demonstrates this by offering treatments that alleviate pain without surgery, recognizing that surgery is not effective for stage 4 esophageal cancer.

Part 2: Institutional Care Delivery

Given the hypothetical patient’s location in Texas, receiving care from a nearby institution, such as Texas Oncology, minimizes transportation costs. Founded in 1986, Texas Oncology operates over 100 offices across Texas, Oklahoma, and New Mexico, focusing on community-based care for underserved urban and rural areas.

Texas Oncology treats various cancers, including stage 4 esophageal cancer, providing personalized care at its cancer center. Services include proton therapy, interventional radiology, oncology surgery, clinical trials, supportive services, genetic risk evaluation, and complementary and alternative medicine. The institution also participates in many health insurance plans, including Medicaid, Medicare, and selected marketplace plans, offering various payment options like credit cards, cash, and checks. Patients paying for their care may qualify for discounts by making advance payments or paying billed amounts on time.

Texas Oncology emphasizes performance improvement through physician accountability, introducing pay incentives tied to achieving benchmarks. The program effectively improves accountability and performance.

To offer optimal care, Texas Oncology affiliates with organizations such as Blood and Marrow Transplant Services, Oncology Pharmacy Services, Inc., Mary Crowley Cancer Research Centers, and the US Oncology Network, among others.

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