Assess The Degree And Quality Of Care

Assess the Degree And Quality Of Care

Please respond to the following: Assess the degree and quality of care established in 18th-century U.S. hospitals, as compared to the level of care seen in 21st-century hospitals. Compare and contrast the U.S. health care delivery system relative to spending per capita and ranking of health care outcomes with the health care systems of two other countries. Determine whether the U.S. health care delivery spending per capita is detrimental to the quality of care provided in the 21st-century hospitals. Provide specific examples to support your rationale from readings throughout your program or from peer-reviewed journal articles.

Paper For Above instruction

The evolution of healthcare from the 18th century to the 21st century in the United States reflects profound changes in the quality, scope, and delivery of medical care. Analyzing these developments involves understanding historical contexts, systemic differences among countries, and the impact of healthcare spending on outcomes. This essay explores the historical standards of care in early American hospitals, compares current practices with those of other nations, and evaluates whether high healthcare expenditures in the U.S. correlate with superior care or if they hinder healthcare quality.

Historical Context of 18th-Century U.S. Hospitals

In the 18th century, American hospitals were rudimentary, often lacking adequate sanitation, trained personnel, and collective oversight. These institutions primarily served as almshouses or poorhouses, providing minimal medical intervention and focusing largely on basic care, with a heavy reliance on home remedies and amateur practitioners. The primary focus was on preserving life rather than improving health outcomes, with minimal technology and knowledge to treat complex conditions (Reiser, 1985). Mortality rates were high, and infections like sepsis and post-surgical complications were common due to inadequate sterilization practices.

Compared to modern standards, 18th-century care was largely palliative and basic, offering little in terms of evidence-based treatment. There were no formal protocols or specialized training, and hospitals served more as custodial institutions than centers of advanced medical care (Rosenberg, 2010). The lack of antibiotics, limited understanding of hygiene, and absence of anesthesia meant procedures were often done without regard to infection control, leading to poor patient outcomes.

Transformation in 21st-Century U.S. Hospitals

Today, the U.S. healthcare system has undergone a complete transformation characterized by technological innovations, specialized care, and evidence-based practices. Modern hospitals have advanced diagnostic tools like MRI and CT scans, sophisticated surgical techniques, and rigorous infection control protocols. Patient safety initiatives, electronic health records, and multidisciplinary teams contribute to higher standards of care (McGinnis & Williams-Russo, 2014). Outcomes such as reduced mortality rates, shorter hospital stays, and improved patient satisfaction highlight the progress.

Despite these advances, disparities remain, and some critiques argue that the cost of high-tech healthcare may not directly translate into better population health outcomes. Ongoing challenges include rising costs, unequal access, and systemic inefficiencies, which can hinder equitable quality care.

Comparison with Healthcare Systems of Other Countries

When comparing the U.S. healthcare system with those of Canada and the United Kingdom, notable differences emerge in expenditure and outcomes. The U.S. spends approximately $12,000 per capita on healthcare (CDC, 2021), the highest among wealthy nations, yet ranks 17th on the World Health Organization’s (WHO) health system performance ranking (WHO, 2020). Conversely, Canada spends around $6,000 per capita and ranks higher overall in health outcomes, including life expectancy and disease management.

The UK’s National Health Service (NHS) provides universal coverage funded through taxation, emphasizing preventive care and primary health services. Although the UK spends less per capita than the U.S., its population health outcomes are comparable or better in many domains. This contrast suggests that higher spending does not necessarily guarantee higher quality; efficiency, care coordination, and social determinants play critical roles (Smith et al., 2019).

Is U.S. Healthcare Spending Per Capita Detrimental to Quality?

There is considerable debate about whether the high healthcare expenditure in the U.S. hampers or enhances care quality. Critics argue that excessive spending, driven by administrative costs, profit motives, and high prices for services and pharmaceuticals, reduces overall efficiency (Hsu et al., 2017). Studies have shown that increased spending does not proportionally improve outcomes, indicating diminishing returns on investment (Levinson & Whelan, 2019).

However, proponents contend that higher spending allows for cutting-edge technology, specialized treatments, and research that improve patient outcomes, especially in complex cases like cancer or cardiac surgery (Squires et al., 2017). Nonetheless, disparities in access—particularly among underserved populations—question whether expenditures translate into equitable or optimal quality care. The fragmentation of the U.S. system often results in duplicated efforts and waste, suggesting that efficiency improvements could enhance care without necessarily increasing costs.

Examples and Evidence from Literature

Peer-reviewed research indicates that countries with universal coverage systems, such as Canada and the UK, achieve comparable or superior health outcomes at lower costs (O’Neill et al., 2018). For instance, the Commonwealth Fund’s reports show that despite higher expenditures, the U.S. does not outperform peer nations in preventable deaths or health disparities. Furthermore, studies have identified administrative costs and price variations as significant contributors to high U.S. healthcare spending (Cohen & Grant, 2020).

Recent reforms focus on value-based care, emphasizing outcomes rather than volume. Programs like accountable care organizations (ACOs) aim to improve efficiency and quality simultaneously. Early evidence suggests that targeted reforms can reduce costs and enhance patient care without compromising quality (McWilliams et al., 2018). These findings imply that systemic reorganization, rather than merely increasing spending, is key to improving the U.S. healthcare system.

Conclusion

The contrast between 18th-century and 21st-century U.S. hospitals exemplifies the remarkable progress in medical science and care quality. While modern hospitals provide sophisticated, evidence-based, and specialized services, systemic inefficiencies and high costs challenge the notion that increased spending directly correlates with superior outcomes. Comparing the U.S. with Canada and the UK highlights that systemic efficiency, universal access, and social determinants are critical factors influencing health outcomes beyond expenditure alone. Therefore, high healthcare spending in the U.S. does not inherently enhance quality and may sometimes be detrimental if it leads to waste, disparities, and inefficiency. Reforms aimed at optimizing resource allocation and prioritizing equitable, value-based care could better serve public health objectives.

References

• Cohen, R. A., & Grant, R. (2020). The high cost of healthcare in the United States. Journal of Health Economics, 72, 102303.
• Centers for Disease Control and Prevention (CDC). (2021). Health expenditure per capita, U.S. 2019. Retrieved from https://www.cdc.gov
• Hsu, J., et al. (2017). Administrative costs in U.S. healthcare. Health Affairs, 36(9), 1622-1629.
• Levinson, W., & Whelan, T. (2019). Diminishing returns on healthcare spending. The New England Journal of Medicine, 380(19), 1806-1808.
• McGinnis, J. M., & Williams-Russo, P. (2014). Achieving a high-quality healthcare system. The Annals of Family Medicine, 12(3), 234-237.
• McWilliams, J. M., et al. (2018). Impact of value-based payment models on healthcare quality. JAMA Network Open, 1(4), e181289.
• Reiser, S. J. (1985). Hospital reform and the development of modern medicine. Medical History, 29(4), 447-468.
• Rosenberg, C. E. (2010). The care of the sick: The evolution of hospitals. Milbank Quarterly, 88(2), 190-232.
• Squires, D., et al. (2017). International variations in hospital spending: An overview. Health Services Research, 52(3), 951-966.
• World Health Organization (WHO). (2020). World health statistics report. Geneva: WHO.