NHS FPX 6008 Assessment 1
[Student Name]
Capella University
Professor’s Name
August 2025
NHS FPX 6008 Assessment 1: Identifying a Local Healthcare Economic Issue
UPMC Bedford has provided the best possible medical treatment to the residents of Bedford and the surrounding areas. Concerns about the medical organization’s inability to guarantee that the community can afford all discharge prescriptions have been highlighted by the new costs of some insulin drugs. According to Scialli et al. (2021), patients who do not take their prescriptions as directed run the risk of experiencing secondary health problems and needing to be readmitted to the hospital. As noted in NHS FPX 6008 Assessment 1, it will be evaluated in light of the flaws that exacerbate this economic problem as well as the immediate and negative effects of rising insulin costs on patients, hospitals, and populations.
Based on hospital readmission reviews, 38 individuals who received home insulin financing were classified as 30-day readmissions. About 50,000 people receive care at UPMC Bedford, a rural community hospital, with 11.6 percent of them living below the poverty line (U.S Census Bureau, 2020). Over 68% of patients treated to UPMC Bedford’s 422 beds in 2023 were released on insulin to treat their type 1 or type 2 diabetes (UPMC, 2023). Patients with either type 1 or type 2 diabetes mellitus can benefit from insulin treatment for hyperglycemia. According to NHS FPX 6008 Assessment 1, individuals who are unable to pay for insulin or other prescription drugs are more likely to experience re-hospitalization, secondary health issues, and death. Hospitals should aim to reduce 30-day readmissions, particularly for patients with diabetes, who account for around 25% of all hospitalizations each year. Furthermore, those with socioeconomic factors are more likely to be hospitalized within 30 days due to their financial insecurity (Sterling et al., 2021).
Rationale for Healthcare Economic Issues
Diabetes, whether type 1 or type 2, is a chronic illness that necessitates daily medication and care. The doctor may suggest several injections, oral medication, lifestyle changes, or both, but these choices are frequently impacted by healthcare economic issues that impact pricing and accessibility. Cardiovascular disease, kidney failure, peripheral neuropathy, vision loss, and the potentially fatal diabetic
ketoacidosis are among the primary and secondary health outcomes that could arise if the illness is not treated by the patient and the healthcare provider (Abdulmalek and Balbaa, 2019). Out of 33 nations with comparable high-income economies, the US has the highest insulin prices. According to Sterling et al. (2021), the average price of insulin in the United States in 2018 was 8.1 times higher than the average prices in Chile (3.9 times), Turkey (27.7 times), and the rest of the world (3.9 times).
The medical-surgical staffing ratios at UPMC Bedford demonstrate this dynamic condition of affairs. According to NHS FPX 6008 Assessment 1, the medical-surgery inpatient staffing ratio changed from one registered nurse per five patients before the pandemic to one registered nurse per eight patients following the epidemic. As part of a larger health care system, UPMC Bedford must adjust its policies and procedures, such as the nurse-to-patient ratio, based on the number of patients and available medical staff. Hospitalization rates during the COVID-19 pandemic in the United States varied according to the period of infection. At UPMC Bedford, discharge phone calls have already started, and most of the inquiries concern discharge medications, including their price, availability, procurement status, and other associated concerns that are representative of key issues in health economics. This measure is necessary to reduce the number of insulin-dependent patients who are likely to be hospitalized due to financial factors, because these figures show that the mortality rate per patient in the hospital is increasing by 47%. This is a critical situation when dealing with chronic patients like diabetes mellitus, as highlighted in NHS FPX 6008 Assessment 1 (Al-Amin et al., 2022).
Direct and Negative Impact
According to the NHS FPX 6008 Assessment 1, people with diabetes who do not take their insulin as directed or who do not obtain it when they need it have a significant impact on communities, healthcare systems, and individuals. When a patient returns to the hospital within 30 days, a stakeholder inquiry should be conducted to determine the reason for the readmission and any preventative measures.
Examining the patient’s prescription and discharge records, determining whether the patient received and took their medication, and further determining the reason for their readmission are all crucial steps health
issues identification. Readmissions have a detrimental effect on the hospital since the patient needs medical and personnel attention. During times of high occupancy, there have been notable variations in the hospital inpatient census. According to published data, if the insurance company had been more focused on things like improving patient disposition, increasing investments, or providing more community resources, or clarifying discharge instructions, almost three out of every four 30-day readmissions would not have occurred (Jatinder Lachar et al., 2023). If the patient discloses that they are unable to pay for their prescription drugs, case management will be asked to look for ways to help them with the cost. Bedford’s 11% poverty rate has socioeconomic ramifications that require a case management system (County Socioeconomic Profile, 2022).
Healthcare Gaps
The financial aspect of affordable healthcare insurance can be difficult to consider as a business case of change management in healthcare reform, and it has to be considered alongside various other considerations, such as feasibility, cost-benefit analysis, and risk management. Since this conversation is an essential part of health problem identification, it is imperative that case managers and bedside nurses have an open discussion about patients’ ability to pay for insulin at home to address this medical issue. Such conversations may cause excruciating discomfort for the sick and their loved ones. However, they are necessary and must be completed before distribution.
A nationwide initiative called Meds to Bed has been formed to help inpatients, such as those who are unable to get their prescriptions filled at home for a variety of reasons, including financial constraints and transportation issues. This service is the only means to solve the problem of patients having to be transported to the pharmacy prior to release so that they receive their prescription medication and new ones, such as insulin.
Over the past nine months, UPMC Bedford has been providing this program to financially and socially struggling patients. The financial aspect of the initiative (case management) will assist patients in making use of all the financial resources necessary to purchase their medication. An inpatient pharmacy is
capable of assisting patients in the meantime with any questions they may have about drugs (Dopp et al., 2020). The shift towards patient-centered care (PCC) and evidence-based medicine (EBM), or evidence-based practice (EBP) is another healthcare transformation that occurred during the last decade (Engle et al., 2021).
Conclusion
The admitted insulin cost shift has had a negative impact on the health of this population. The NHS FPX 6008 Assessment 1 investigation examined the outcomes of rising insulin prices on patients, communities, and hospitals to establish the causes of this financial issue. When a patient develops secondary health issues due to their diabetes or has a new diagnosis, they have to be provided with high-quality care and take insulin and prescription medications as prescribed.
References
County Socio-economic Profile. (2022). https://agwebv01.ag.utk.edu/agecon-tableau/Bedford.pdf
Dhaliwal, J. S., & Dang, A. K. (2024). Reducing hospital readmissions. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK606114/
Dopp, A. R., Narcisse, M.-R., Mundey, P., Silovsky, J. F., Smith, A. B., Mandell, D., Funderburk, B. W., Powell, B. J., Schmidt, S., Edwards, D., Luke, D., & Mendel, P. (2020). A scoping review of strategies for financing the implementation of evidence-based practices in behavioral health systems: State of the literature and future directions. Implementation Research and Practice, 1(July-September), 263348952093998. https://doi.org/10.1177/2633489520939980
Enabnit, A. (2023). Discharge Planning: Ensuring a Smooth Transition from Hospital to Home – DoveMed. DoveMed. https://www.dovemed.com/health-topics/focused-health-topics/discharge- planning-ensuring-smooth-transition-hospital-home
Engle, R. L., Mohr, D. C., Holmes, S. K., Seibert, M. N., Afable, M., Leyson, J., & Meterko, M. (2021). Evidence-based Practice and patient-centered care: Doing Both Well. Health Care Management Review, 46(3), 174–184. https://doi.org/10.1097/HMR.0000000000000254
Herman, W. H., & Kuo, S. (2021). 100 years of insulin: Why is insulin so expensive and what can be done to control its cost? Endocrinology and Metabolism Clinics of North America, 50(3), e21– e34. https://doi.org/10.1016/j.ecl.2021.09.001
Jatinder Lachar, Avila, C. J., & Qayyum, R. (2023). The Long-term Effect of Financial Penalties on 30- day Hospital Readmission Rates. https://doi.org/10.1016/j.jcjq.2023.06.001
Scialli, A. R., Saavedra, K., & Fugh-Berman, A. (2021). The benefits and risks of adherence to medical therapy. The Journal of Scientific Practice and Integrity, 3(1). https://doi.org/10.35122/001c.21386
Sterling, M. R., Ringel, J. B., Pinheiro, L. C., Safford, M. M., Levitan, E. B., Phillips, E., Brown, T. M., Nguyen, O. K., & Goyal, P. (2021). Social determinants of health and 30-day readmissions among adults hospitalized for heart failure in the REGARDS Study. Circulation: Heart Failure, 15(1). https://doi.org/10.1161/circheartfailure.121.008409
