NHS FPX 6008 Assessment 1
[Student Name]
Capella University
[Prof. Name]
September 2025
NHS FPX 6008 Assessment 1: Identifying a Local Healthcare Economic Issue
Since its inception, the provision of the highest quality of medical care to the people of Bedford and the communities around it has been the priority of the UPMC Bedford. The new costs of some insulin drugs have contributed to concerns regarding the inability of the medical organization to ensure that the community can afford all discharge prescriptions. Scialli et al. (2021) explain that patients who fail to take their prescriptions as prescribed are at risk of developing secondary health issues and have to be admitted to the hospital again. It will be assessed based on the weaknesses that contribute to this economic issue and the direct and adverse impacts of insulin price increases on patients, hospitals and population as mentioned in NHS FPX 6008 Assessment 1.
According to home insulin financing reviews based on the hospital readmission statistics, 38 people were considered 30-day readmissions. UPMC Bedford is a small-town healthcare facility providing services to about 50,000 residents, and 11.6 percent of the population in the facility lives below the poverty line (U.S Census Bureau, 2020). In 2023, more than 68% of the patients discharged out of 422 beds at UPMC Bedford left with insulin to manage their type 1 or type 2 diabetes (UPMC, 2023). Insulin treatment of hyperglycemia can be useful in patients with either type 1 or type 2 diabetes mellitus. As stated in NHS FPX 6008 Assessment 1, patients who cannot afford insulin or other prescription medications are more prone to re-hospitalization, secondary health complications and death. Hospitals need to strive to minimize 30-day readmissions, especially of diabetic patients who make up approximately a quarter of all hospitalizations annually. Above all, patients with socioeconomic problems are likely to be hospitalized again within 30 days due to being financially unstable (Sterling et al., 2021).
Rational 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. The most
significant and secondary health outcomes that might occur when the disease is not managed by the patient and the healthcare provider include cardiovascular disease, irreversible kidney damage, peripheral neuropathy, the loss of vision, and even deadly diabetic ketoacidosis (Abdulmalek and Balbaa, 2019). Among 33 countries with similar high-income economies, the US is the country with the highest insulin prices. Sterling et al. (2021) suggest that the price of insulin in the United States in 2018 was on average 8.1 times higher than the price in Chile (3.9 times), Turkey (27.7 times), and the rest of the world (3.9 times).
This dynamic state of medical-surgical staffing is evidenced by the UPMC Bedford medical-surgical staffing data. In NHS FPX 6008 Assessment 1, the medical-surgery inpatient staffing ratio increased to one registered nurse per eight patients after the pandemic, as compared to one registered nurse per five patients before the pandemic. As part of a larger health care system, UPMC Bedford must adjust its policies and procedures, which can list out the indicators of economics health 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 important issues in health economics. Tis is to decrease the insulin dependent patients who will be likely to be hospitalized on financial grounds since these number indicate that the mortality rate per patient is rising by 47 in the hospital. This is a play or die situation with chronic patients such as diabetes mellitus as clearly indicated in NHS FPX 6008 Assessment 1 (Al-Amin et al., 2022).
Direct and Negative Impact
NHS FPX 6008 Assessment 1 suggests that individuals with diabetes who fail to take them as recommended or who fail to acquire them when they require them, have an enormous influence on the community, patient care systems, and patients. Stakeholder inquiry is to be carried out when a patient has returned to the hospital within 30 days to check the cause of the remission and preventative actions.
Health issues identification through 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 in determining the patient’s readmission and how best to help them. Their readmissions impact the hospital negatively as the patient requires medical and personnel care. The hospital inpatient census has been fluctuating significantly during the high occupancy periods. Published data suggest that nearly three of every four 30-day readmissions would not have happened had the insurance firm been less concerned with things like enhancing patient disposition, making more investments, or offering more resources to the community, or clarifying discharge instructions (Jatinder Lachar et al., 2023). In the event that the patient reveals that he or she cannot afford to cover their prescription medications, case management will be requested to seek methods to assist them in the expense. The case management system must be introduced to the people of Bedford because of the socioeconomic outcomes of poverty rate 11% (County Socioeconomic Profile, 2022).
Healthcare Gaps
A tertiary academic medical center’s case managers (CMs) conducted pilot research in which they asked all patients who participated in daily multidisciplinary discharge rounds (MDRs) about their post-discharge resource requirements. 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. These discussions can be painfully embarrassing to the family and the invalid. They are, however, required and need to be done prior to distribution. This team will ensure that the patient leaves home with all the prescribed products, including maintenance and recovery medications, follow-up appointments with primary care and specialists, home health services, etc. (Enabnit, 2023).
An initiative known as Meds to Bed has been established nationwide to assist inpatients including those who cannot fill their prescriptions at home due to various reasons including financial limitations and
transport problems. This is only one of the ways of solving the problem of patients having to be transported to the pharmacy before they are discharged to collect their prescription medications and new ones such as insulin.
UPMC Bedford has been providing this program to patients struggling financially and socially in the past nine months. The financial aspect of the initiative (case management) will assist the patients in utilizing all the financial means necessary to purchase their medication. An inpatient pharmacy can currently provide patients with help in case they have any questions about medications (Dopp et al., 2020). The other healthcare shift of the last decade is the transition to patient-centered care (PCC) and evidence-based medicine (EBM) or evidence-based practice (EBP) (Engle et al., 2021).
Conclusion
This population has been greatly affected negatively by the insulin cost shift that was now acknowledged by UPMC Bedford. To find out the cause of this financial issue, the investigation conducted in NHS FPX 6008 Assessment 1 examined the impact that the soaring insulin price has had on patients, communities, and hospitals. When a patient develops secondary health issues due to his or her diabetes or is newly diagnosed, they need high-quality care, must take insulin and prescription medications as instructed, and when they develop secondary health issues.
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
