Healthcare Regulations, Readmission, And The Budget Paper

Healthcare Regulations, Readmission, and the Budgets Paper topic/Hypothesis

How lack of medication regulation and readmission drive up hospital cost and cause drifts in planned budgets for hospitals.

What we mean when we talk about healthcare policies is a set of preemptive regulations established to enhance healthcare delivery. The program addresses many concerns, including but not limited to; healthcare financing, protracted care, mental health, and preventative medicine. One of the most pressing problems in the United States we must solve now is how to improve healthcare delivery. People have been able to live healthier and longer lives thanks to increased Medicare expansion in recent decades.

This study intends to investigate healthcare reform and the policies from different areas of healthcare inside the United States. This review takes a look at different diseases, measures of analysis, and studies done in relation to planning and policies in reflection of mortality rates and readmission of patients in different hospitals.

Introduction

Healthcare policies refer to a set of regulations designed to improve healthcare delivery by addressing various issues such as healthcare financing, patient safety, medication management, and hospital operations. A major concern in US healthcare is the rising cost of hospital operations, largely driven by preventable readmissions and medication errors. These issues not only affect patient outcomes but also lead to significant financial burdens on hospitals and distort budget planning. Improving medication regulation and reducing unnecessary readmissions are thus critical for controlling costs and enhancing quality care.

This research aims to analyze how deficiencies in medication regulation and high readmission rates impact hospital costs and disrupt planned budgets. It will explore the role of healthcare policies in mitigating these issues and propose evidence-based improvements. The overarching research questions include: How does inadequate medication management contribute to readmissions and costs? What policy interventions can effectively reduce readmission rates and medication errors? The ultimate goal is to identify strategies for optimizing hospital resource utilization and financial planning through better regulation and patient care protocols.

Literature Review

Extensive research highlights the critical role of medication safety and hospital readmissions in health outcomes and healthcare costs. Buerhaus et al. (2017) emphasize disparities in the quality of healthcare delivery between private practices and hospital settings. They note that preventable medical errors are a leading cause of mortality, with medication errors accounting for a significant portion (Frisina & Neri, 2018). Such errors often result from inadequate regulation, poor communication, and fragmented care processes.

The integration of pharmacists into patient care teams has shown promise in reducing medication-related problems (Pellegrin et al., 2017). Collaborative medication management enhances adherence to safe practices, particularly among geriatric populations, who are more vulnerable to adverse drug events (Smith et al., 2016). However, despite awareness of these issues, medication errors persist, leading to increased readmissions (Jones & Treiber, 2018). This continuous cycle exacerbates hospital costs by repeating acute interventions, prolonging stays, and increasing resource utilization.

Hospital readmission rates serve as important indicators of healthcare quality and financial efficiency. According to Upadhyay (2019), declining readmission rates are associated with better patient management and increased hospital revenues, yet reductions often require investments in staff training, technology, and systemic reforms. The Hospital Readmission Reduction Program (HRRP), introduced under the ACA, penalizes hospitals with higher-than-expected readmission rates for conditions like heart failure and pneumonia, incentivizing reductions (Gupta & Fonarow, 2018).

Nevertheless, some critics argue that the focus on reducing readmissions without addressing underlying causes, such as medication mismanagement or social determinants of health, can lead to unintended consequences, including rushed discharges or inadequate post-discharge support (Wong et al., 2011). Additionally, inadequate medication regulation exacerbates the risk of adverse drug events, which are associated with increased hospital admissions and treatment costs (Alper et al., 2015). Consequently, a comprehensive approach combining policy reform, better medication regulation, and care coordination is essential for sustainable improvements.

Measures of Analysis

This study employs hospital-level metrics such as mortality rates and readmission rates to evaluate policy effectiveness and cost implications. Mortality rates reflect the quality of care and safety, while readmission rates indicate continuity of care and community support post-discharge (Vollam et al., 2018). Analyzing these indicators provides insights into how medication regulation and discharge planning influence hospital expenses.

Research by Upadhyay (2019) shows that hospitals with lower readmission rates tend to have better operational margins, albeit sometimes with increased investments in patient management systems. There is a paradox where efforts to reduce readmissions may initially elevate costs due to enhanced care protocols, yet they lead to long-term savings by avoiding costly readmissions (Allen, 2015). Moreover, examining the costs associated with medication errors reveals substantial financial burdens on hospitals, including extended stays, legal liabilities, and re-hospitalizations (Hamsen et al., 2020).

Cost analysis strategies involve quantifying resource utilization, including staffing, medication, diagnostic procedures, and hospital stay durations. Economic models will compare savings achieved via policy interventions against the initial investments required. This approach aligns with the principles outlined by Nolan et al. (2016) on optimizing healthcare expenditure through systemic reforms.

Conclusions

The investigation underscores the complex interplay between medication regulation, readmission rates, and hospital financial performance. Insufficient regulation of medication practices often leads to adverse events, which contribute significantly to preventable readmissions and inflated hospital costs. Policies aimed at strengthening medication management, such as mandatory pharmacist involvement and electronic prescribing systems, demonstrate potential in reducing errors and subsequent readmissions.

Furthermore, adopting comprehensive discharge planning and post-discharge support can mitigate unnecessary hospital returns, improving patient outcomes and stabilizing hospital budgets. Strategic investments in technology, staff education, and community engagement are critical components of effective policy reform. Ultimately, aligning healthcare policies with robust medication regulation and integrated care pathways offers a pathway toward more sustainable hospital operations and better health outcomes.

References

• Alper, E., O'Malley, T. A., Greenwald, J., Aronson, M. D., & Park, L. (2017). Hospital discharge and readmission. UpToDate.
• Allen, L. A. (2015). Hospital readmissions reduction program. Circulation, 131(20), 1797-1799.
• Buerhaus, P. I., Skinner, L. E., Auerbach, D. I., & Staiger, D. O. (2017). Four challenges facing the nursing workforce in the United States. Journal of Nursing Regulation, 8(2), 40-46.
• Frisina, L., & Neri, S. (2018). Redefining the state in health care policy in Italy and the United States. European Policy Analysis, 4(2), 125–137.
• Gupta, A., & Fonarow, G. C. (2018). The Hospital Readmissions Reduction Program—learning from failure of a healthcare policy. European Journal of Heart Failure, 20(8), 1095-1099.
• Hamsen, U., Drotleff, N., Lefering, R., Gerstmeyer, J., Schildhauer, T. A., & Waydhas, C. (2020). Mortality in severely injured patients: nearly one of five non-survivors have already been discharged alive from ICU. BMC Anesthesiology, 20(1), 1-8.
• Jones, J. H., & Treiber, L. A. (2018). Nurses' rights of medication administration: Including authority with accountability and responsibility. Nursing Forum, 53(3), 278-285.
• Kà¶berlein-Neu, J., Mennemann, H., Hamacher, S., Waltering, I., Jaehde, U., Schaffert, C., & Rose, O. (2016). Interprofessional medication management in patients with multiple morbidities: a cluster-randomized trial (the WestGem Study). Deutsches Ärzteblatt International, 113(44), 741–749.
• Vollam, S., Dutton, S., Lamb, S., Petrinic, T., Young, J. D., & Watkinson, P. (2018). Out-of-hours discharge from intensive care, in-hospital mortality and intensive care readmission rates: a systematic review and meta-analysis. Intensive Care Medicine, 44(7), 1136-1146.