Health care encapsulates the measures taken through use of medical and nursing procedures. Health care comprises of medicated, surgical and non surgical procedures for prevention or recovery from undesirable health conditions. The current study focuses upon the reviewing and evaluation of predictive tools that can assist towards risk modeling in health and medical services. Recent tools such as ACG and DxCG are beneficial in light of examining health care practices and endogenous medical risks. Through linking of medical database with different set of medical and health practices the decision making ability of doctors are enhanced. Further, through use of predictive modeling the equitable distribution of medical facilities among the population are ensured. Sampling and observations of randomized clinical trials along with structured analysis of medical database sets are proven to be essential in forecasting of unintended health issues. Execution and impact of health care services are gauged using the volume of health care reforms and the overall trend towards mitigating health risks. Moreover innovations in terms of surgical interventions and medical research have a crucial role to play in terms of determination of diagnostics to be followed along with the rate of recovery. Numerous financial factors in terms of capital procurements by the health care service providers, the requirements of high initial capital for medical services and the level of expenditures on intervention patents affects the operating activities of the health care firms.
Risk modeling comprises of construction of frameworks relating to probable form and degree of
risk that are both endogenous and exogenous to any industry. In terms of health care industry, there are several factors that contributes towards high risks such as malpractices in health care services, risks relating to the misdiagnose practices, mistreatments, or wrongly prescribed medications, moreover laxity in terms of medical supervision and ignorance in nursing practices.
Findlay et al. (2014) states that surgical risks increase in health care set up where adequate preventive measures are not followed. Furthermore, Barrieu et al. (2012) mention that modeling risks has a certain set of limitations depending upon the assumptions of risk parameters that are taken into account.
There are several sets of exogenous risks entailing the health care industry; primary among them being compliance risks imposed upon by the health care regulators. In addition, health care also has risks related to false insurance claims, security breach in IT infrastructures along with system failures leading to compromising patient’s medical databases, records of pathological tests, treatment routines and timetables for medication. As stated by Diers & Linde (2013) insurance risks has a cascading effects on health care policies in absence of proper set of regulations. The risks that patients undergo in terms of unplanned hospitalization followed by high health care costs requires evaluation. As per Elwyn et al. (2012), linking of databases of patient’s hospital records with reports of private physicians are essential in predictive health care risk modeling to improvise the probability of risk detection. Predictive modeling tools such as Adjusted Clinical Groups (ACG) or the DxCG assists towards streamlining the accuracy rate in examination of risks. Further, the inherent medical and health care risks pertaining to population irrespective of patient’s past medical history are mitigated through intricate co-ordination between the patient, the health care provider, patient’s physician and the providers of medical insurance.
Chai, Liu, & Ngai (2013) mention that construction of decisions making models encompass attention to several parameters. These parameters include environment of decisions, problems, approaches in decision making. In terms of health care services numerous factors come into consideration for decision making such as agency functions and decision making authorities endowed by doctors. Moreover, Longo & Wright (2012) mentions that scarcity in terms of informed choices and restriction in terms of patient’s capabilities has increased the degree of authoritative decision making by the doctors and health care practitioners. The probability of likely use of appropriate medical services and resources diminishes with the unfavorable perception of general health care products. Colombo (2016) stressed upon the significance of patient participation in formulating health care reforms and framing of surgical and medicated services. Further, Dang & Manjunath (2016) inferred that decision making in health care through randomized trials require additional set of statistical tools such as observation series of medical data. Therefore, it can be observed that even in decisions pertaining to medicated services there is scope to improve the forecasting of health issue of individual patients. The moral and ethical issues pertaining to conflict of interests at hospitals, medical insurance businesses, and principal agent crisis forms relevant parameters for assessing decision making in health services. Ethical issues that occur from inequitable treatment of patients, resulting towards a biased set of health care practices, could have long run repercussions on the physical condition of the patients. Through exponential reduction in decision making autonomy of patients the health care system derives a paternalistic authority on treatments and medication. Such measure weakens the role of principals and aggravates the agency crisis.
Karabarbounis & Neiman (2014) stated that amortization and depreciation policies that are dependent upon the audit regulators play a crucial role towards representation of levels of capital expenditures. Health care services entail installation of both invasive and non invasive sets of equipments in order to cope up with the diagnostic and prognosis activities. The set of guidelines followed for amortization of surgical, pathological and diagnostics equipments are distinctive as compared to other sectors. The obsolescence of equipments is based upon emerging health practices and innovations occurring in terms of medicated practices. Tax relief for medical and health care expenses by patients increasingly compliments health care reforms. Moreover, McDonough (2013) states that impact on tax exemptions have a positive expansion of medical and clinical facilities in an economy. Taxes on health insurance premiums impede the rate of coverage in the overall population. Furthermore, improvement in the health service industry has a knock on effect on others sectors of the economy. Positive reinforcements of the health sector are leads to higher productivity in terms of human capital of the economy. In addition, improvements on average lifespan of population tend to increase leading to higher levels of marginal consumption along with GDP growth. Tax exemptions for the employers providing the healthcare costs of employees and their family members are a definite way of incrementing the level of awareness about benefits of medical supervision.
Maggiori & Gabaix (2015) mentions that unfavorable exchange rate volatilities results in flow of goods and services from countries with highly volatile resources to regions where currency rate volatility are less frequent. The health care sector of an economy has a considerable dependence of the exchange rates of indigenous currency. Exchange rate impacts the health care tourism industry severely in terms of number of outgoing patients. The decision as regards to surgical and medicated treatments depends on the health care costs and availability of affordable health care packages. Fetscherin & Stephano (2016) states that the growth of medical tourism affected by the income levels of the patients and their employers. The degree of favorable exchange rates leads to increasingly affordable health care facilities resulting in a upswing in the economies providing such health care as compared to loss treatment opportunities by other economies. Lee (2014) states that the medical communication is bolstered in case of diminishing exchange rates as the demand for health care services improve drastically. As per Christensen, Floyd & Maffett (2015) states that regulations in terms of price transparency in medical and health care industry leads to reduction in common sets of prices that are charged along with increase in sensitivity towards demand of medical care. Thereby, prices regulations results in increasing the number of individuals seeking medical attention. On an individual level, budgetary issues relating to affordability of healthcare results in alterations in demands of medical care.
Replacements analysis in terms of health care and medical facilities encompasses two sets of evaluation. The primary replacement decisions pertain to invasive surgical operations whereas the replacement regarding surgical and non surgical equipments is also taken into account in drawing up replacement decisions. Judgments as regards to replacement surgeries are imperative towards improving the productivity in operating activities. Nazif et al. (2014) states that in terms of minimally invasive cardio surgeries the decision making process undertaken by the cardiologists determines the level of recovery for patients. In terms of health care, the replacement of medical equipments is imminent in order to cope up with improvised sets of treatments. Moreover, the amount of innovations in diagnostic technologies leads to reduction in usability of a majority of medical equipments. Even in cases of instruments that is not affected by the improvements in technology, reliability as regards to the readings and measurements vary according to the time period between date of manufacturing and the date of last use. Precision of surgical and diagnostics diminishes over the period resulting in inaccurate processing of medical data. Burgess et al. (2014) mentions that through survey in multicentre health care facilities that assessment of pain, quality of life is dependant up on the degree of precision through which the surgical procedures are followed. The service providers should focus on minimizing the level of replacement operations, irrespective of reduction of revenues from invasive surgeries, in order to mitigate the anticipated risks of health measures.
Gartner, Frid & Alexander (2012) states that sources of finance plays a crucial role towards determining the degree of risks that pertains to individual sectors of the economy. Several alternatives of financing exist with separate levels of risks. However, in case of health care sector, the sources of financing are limited even though capital is available at favorable rate of interests. Factors to be considered in health care financing comprises of revenue generating capabilities of an organization as compared to the required quantum of capital. In terms of financing, health care requires large capital procurements for initiating health care facilities along with expansion of Medicare activities. Willan & Eckermann (2012) states that the price threshold in terms of using patented technologies in health care depend on the affordability of service by the patients and their employers. Moreover, in case of intervention technologies in medical services the tradeoff between affordability of services and the benefits derived from such services are subjective in nature. The initiation of additional sets of medical research requires large funding because of which majority of interventional and surgical innovation entails high costs of installing and operating. Investment and business expansion in terms of increasing the amount of healthcare products and services may result towards expanding the demand and improving marketability of health services. On the patient side multiple methods of financing their healthcare are available in terms of medical insurance policies, employer’s health assurance services and different set of financial packages.
The initiation of multiple levels of medical and health care packages in order to cater to large segments of populations increases the volume of treatments sought by average individuals. The introduction of innovative health care methods after thorough evaluation using randomized trials has long term benefits. Even though implementation of newly developed surgical methods and instruments encompasses high amount of costs, the relative benefits to the patients both in terms of immediate ailments and longevity. The framing of depreciation policies should be such a way so as to take into account the degree of obsolescence in diagnostic practices. Drawing of affordable facilities and regulations in terms of pricing strategies can improve the demand for medical care. Moreover, the quality management in nursing facilities and post surgical services could result in better rate of recoveries for the patients. The conglomeration of medical expertise results in treatment of patients at multiple levels of health issues. Health care providers should focus upon implementing a robust set of disease management measures in order to mitigate health risks. A case by case approach for customizing the set of services could result in addressing health issues in a productive manner. The priorities of health care facilities should be on the recovery of patients rather than increasing the revenue generating capabilities. In the longer term, the levels of satisfaction derived from a particular health care will affect the organizations prospects.
Health care practices are based upon ethical and moral grounds in terms of decision making. Innovations play an imperative role in terms of accuracy of diagnosis and health advices, therefore investment in modern health care equipment and practices are relevant. The prioritizing of revenue generating abilities over patient’s welfare results in reduction of demand for health services. Moreover, the approach of health care practices should be such so as to cater to the patient’s individual medical needs. The level of malpractices in an organization providing such services has multiple levels of repercussions in terms of inattentive medical care, side effects from health practices, adverse health effects. Therefore, the service providers should regulate the health practices at the organizations.
Disease management through apportionment of health services to the doctors with the appropriate levels of expertise reduces the incidences of wrongful diagnosis. In case of implementing new sets of medical practices orientation training of nursing and other medical staff is prerequisite. Further, the co-ordination between the doctors, the nursing staff, the dieticians, and the rest of the medical staff are imperative in order to ensure proper treatment and heath care services. The screening process along with pathological tests and therapies requires monthly evaluations in terms of industry wide best practices. Any change in industry practices or changes in approach towards medical decision making should be included periodically into the services of the health care organizations.
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