Good day, I am seeking assistance to review 2 papers and write 1 rubric for each paper.

THE IMPACT OF URINARY ISSUES IN THE HEALTHCARE SYSTEM

What is the impact of not having access to health insurances for females who suffers from urinary issues?

Abstract

Females who suffer from urinary issues such as overactive bladder and interstitial cystitis, and do not have access to health care tend to worsen their health condition. Some females are not aware of how dangerous and painful these urinary issues can be without the proper and enough medical services and income/health insurance. The research proposal will inform about how urinary issues is becoming a huge liability to the health care industry, the reason patients with urinary issues do not visit their doctors and how is affecting people emotionally and physically. The proposal of this research paper is to create a strategy to decrease the number of women with urinary problems who have no income/health benefits for treatments/medical services, to educate and encourage them to intervene until the disorder becomes a long-term issue.

From an article (must be my research method): Furthermore, a cross sectional study was performed to examine discrepancies between patients with bladder pain syndrome (BPS)/interstitial cystitis (IC) and patients without these urinary issues. The study indicated that patients (females) between the ages of 48-50 and older, patients with bladder pain syndrome/interstitial cystitis (174%) use a relatively larger volume of health care services than the control group, people without BPS/IC (150%) in Taiwan. This study shows how important is for the health care system to focus on these individual, especially females who suffers from urinary problems because not having the necessary resources such as medical assistance, income and health education could lead to other medical complications such as affecting their emotions and physical.

Research Goals and Objective

The objective of this research proposal is to find out the consequences that females can face due to lack of health insurance access and how it can increase the condition to become dire. The goal of this research proposal is to construct a plan to decrease the number of females with urinary issues that do not have income resources/health coverage for the treatments/services and, inform and advocate them to act before the condition becomes a long-term process. Therefore, the research proposal will provide the resources needed to prevent the expansion and the risks for the issue to get dire.

Studies have shown that interstitial cystitis (IC) is one of the most expensive illnesses to the health care industry and it will be kept increasing (Chung, S. D., Liu, S. P., Li, H. C., & Lin, H. C. (2014).

Based on the Health care service utilization among patients with bladder pain syndrome/interstitial cystitis in a single payer healthcare system by Chung and other authors, patients with bladder pain syndrome (BPS)/IC consume more healthcare supplies/funds than those who are not diagnosed with BPS/IC. For that reason, patients with urinary issues must still be provided with medical resources and there should be a way to provide enough medical needs to those who cannot benefit from health insurances. Most importantly, the live of all females with urinary issue matter and the goal of every specialist should be to give all the medical resources to prevent the damage to evolve in the bladder. But, in many cases, health insurances cannot cover most of the health services; imagine those females with urinary issues without health insurances, the case is worse.

However, the health care industry has evolved and seems to be providing better care to patients with urinary issues than in the past. According to Medical care of overactive bladder in elderly patients by Jensen, G. A., Zhiyuan Zhou, & Yasuhiro Torigoe, studies have shown that elder patients with urinary issues do not seek for medical help because they feel uncomfortable informing doctors. The health care industry must find ways to help patients who are unwilling to visit doctors because it makes them feel awkward to tell their urinary issues. For this reason and many reasons, this research proposal is being created to help the group of people, elder, who are not receiving what they need to help them be healthy and feel happy.

Literature Review

Urinary issues are the most uncomfortable condition women could ever experience. Overactive bladder (OAB), chronic/interstitial cystitis (IC) and stress urinary incontinence (SUI) are three of the most common urinary issues that affect female’s in every sense such as social life, mentality and physically. It has been difficult to find out because the symptoms are variable. Typically, pain creates another pain and affects other parts of the human body.

Overactive bladder is a condition in which the bladder releases urine at any time; not letting the bladder fills up fully. Interstitial cystitis is also known as a chronic problem.

It consists of a few symptoms such as feeling pressure and pain the pelvic area, especially the bladder. The last urinary issue is urinary incontinence, is an uncontrollable condition because is an involuntary leakage of urine. Furthermore, in order to treat these types of urinary conditions, patients must have access to health insurances or income, a form of payment to cover all the medical needs. The medical services for these conditions are very expensive and the price will keep increasing, as researchers have shown. Also, urinary issues are affecting emotionally and physically the health of people. Some of the people do not seek for help because they dislike informing the condition and others believe, especially women, giving birth is the main cause of developing urinary issues/ overactive bladder. There are many things that could be done to reduce and help individuals with urinary issues.

To start off, overactive bladder is and it’s becoming the most high-priced illness. The more patients there is to treat the symptoms of urinary issues, the more medical needs are needed to treat the condition. According to Socioeconomic costs of overactive bladder and stress urinary incontinence in Korea by Wooseuk and other authors, “those that used incontinence pads, only 45% visited their doctor for bladder problems, leaving 55% who probably relied on self-treatment [21]. More seriously, 12.6% of those with UI visited their doctor, yet only 0.8% of those had surgery for incontinence”. In other words, a big percentage of people decided to not go back for check-ups, and this brings a lot of questions to mind. The main question is “Why are they not coming back?” and the answer must and should only be collected from those 50% of people that didn’t visit the doctor again. The focus of the research proposal is to find out if health insurances have anything to do with their visits. Are health insurances plans limiting the use of resources/services? Are they not paying for better treatments? Some individuals start to make home remedies when they see that medical services are not improving their health. According to Medical care of overactive bladder in elderly patients by Jensen and other authors, “The findings from epidemiologic surveys, as well as analyses of actual medical encounter data, indicate that treatment rates for OAB are very low”.

Meaning, researchers had use surveys to find out why the rate for OAB treatments is too small. There is a possibility that doctors are not giving more options to patients or health insurances cannot cover certain treatments. Wooseuk and the other authors mentioned in his article, “In Korea, although the consequences associated with OAB and SUI result in adverse effects on quality of life and increasing medical cost, a very small number of patients used medications because of a lack of social recognition”. As we can from this article, the country Korea is concerned for the socioeconomics costs of overactive bladder and stress urinary incontinence because medical costs keep arising and negative effects are occurring to the patients because a big number of patients are not taking the medicines given by the doctor due to lack of social acceptance.

Furthermore, patients with urinary issues need to visit more their doctors than patients who do not suffer from the condition. According to Health care service utilization among patients with bladder pain syndrome/interstitial cystitis in a single payer healthcare system by Chung, “IC is a costly disease to the health care system. Clemens et al. reported that the mean yearly costs were 2.4-fold greater for the patients with IC than for controls without in a managed care population” In this study, researchers took two group of people: the patient with IC and the patients without IC (controls) with the same health insurance (Taiwan’s National Health Insurance) to investigate which of the groups consumed more medical needs and the findings demonstrate that people with IC consume the most. Based on Health care service utilization among patients with bladder pain syndrome/interstitial cystitis in a single payer healthcare system by Chung, “Wu et al. indicated that the average IC patient has 130% higher direct costs than the average non-IC patient based on claims data from several managed care plans”. The health care industry is noticing that patients with IC are consuming and attending to health organization more than people who do not have the condition. Due to the urinary condition, it’s best for doctors to make home visits. Most of the people facing this health issue are elderly around the ages of 45 and above. Care providers will have different views towards home visits. Some might believe that they do not have all the necessary equipment’s to check their patients at home.

Others might believe that this is a good idea because it helps the patients to feel comfortable and prevent them getting into heavy traffics. According to home visits - central to primary care, tradition or an obligation? A qualitative study by Theile and other authors, “Today in most European countries and the United States home visits are the exception and are no longer the standard method of health care delivery - although there is diversity between individual general practitioners (GPs) and different countries… the number of home visits is continuously declining while the primary target group, namely older, multimorbid people, is growing”. This is not a good sign for those individuals who would like to see their doctors at home and their condition has reach the extreme stage meaning those individuals who cannot even go outside because they have the sensation of wanting to urinate.

Moreover, and unfortunately, urinary issues lead to other non-related and related issues, affecting people in every sense; emotionally and physically. Based on Health care service utilization among patients with bladder pain syndrome/interstitial cystitis in a single payer healthcare system by Chung and other authors, “Patients with IC may not only have a reduced quality of life, but are also more likely to suffer from other physical or mental co-morbidities as compared to the general population”. The following article mentions how this horrible condition makes them feel and misunderstand the cause of the urinary issue, basically they make assumptions. Both genders: males and females came up with these responses regarding their urinary condition. Based on Medical care of overactive bladder in elderly patients by Jensen and other authors, “Many persons are too embarrassed to discuss this condition with a healthcare professional, and many people believe that urinary problems are an inevitable part of getting older.3,8 Women are especially reluctant to seek treatment, as they often believe that midlife symptoms of OAB are the inevitable byproduct of childbirth.” Patients with OAB tend to not socialize, they do not sleep and rest well during nighttime and they become depressed due to pain and other related factors. As Jensen and other authors stated in Medical care of overactive bladder in elderly patients by Jensen and other authors, “OAB is also associated with an increased rate of depression, emotional disturbances, sleep disorders resulting from nocturia, and social isolation.

In one study, adult women who suffered from symptoms of urge incontinence had a higher dysfunction level affecting their quality of life than women with symptoms of stress incontinence”.

To conclude, the urinary issues have been affecting not only females, but also males and especially elder individuals. There are many types of urinary issues and all of them affect the life of people with this condition. The health care industry is noticing and detecting the socioeconomic costs and the utilization of medical needs that these individuals need. Studies are showing them that everything will be increasing, and the health care system should prepare and help treat the condition to improve the quality of life of patients with urinary issues. Also, researchers have demonstrated that people with urinary issues are coming more to see their doctors than those who do not have the symptoms of urinary issues. Therefore, the health care system should allow doctors to make home visits for patients who suffer from uncontrollable issue. Also, other studies have shown how the conditions affect the behavior and the views of people. People with this condition are not sleeping enough, they do not go often outside due to leakage and they are becoming depressed due to pain and are limited to do certain activities. Importantly, people who have urinary issues and do not have coverage for the treatments are more at risks than those have sort of help to cover the treatments. The goal of the health care system should be to provide as much as they can to these individuals because as soon as people start reaching the elder stage, the health care system will see a lot of new cases. The best way to avoid this issue is to plan a strategy and perform it now to be safe in the future and improve the quality life of humanity.

Needs Assessment

Method

Study Design:

Cohort (investigate what will happen; looking for the risks) or case control (it’s good to study rare conditions and conditions that develop over a long time).
If I decide to choose case control, I would have a control group, which will be the group that receives health education workshops.

Population Sampling:

Elder (45-55),
Providing survey, interviewing participants or looking at their medical record (Cohort)

Ethics

Researchers must make sure to find patients who have chronic interstitials cystitis; not acute cystitis because the researchers need to focus in one group. (sampling)
Privacy: the selected participants might not want to share their personal health issue.

Logic Model

References

Chung, S. D., Liu, S. P., Li, H. C., & Lin, H. C. (2014). Health care service utilization among patients with bladder pain syndrome/interstitial cystitis in a single payer healthcare system. PloS one, 9(1), e87522. Retrieved from https://doi.org/10.1371/journal.pone.0087522

Wooseuk Sung, Hyunwook You, Tai Young Yoon, & Sun-Ju Lee. (2012). Socioeconomic costs of overactive bladder and stress urinary incontinence in Korea. International Neurourology Journal, 16(1), 23-29. Retrieved from https://www.einj.org/upload/pdf/inj-16-1-23-4.pdf

Reeves, P., Irwin, D., Kelleher, C., Milsom, I., Kopp, Z., Calvert, N., & Lloyd, A. (2006). The current and future burden and cost of overactive bladder in five European countries. European Urology, 50(5), 1050-1057. Retrieved from https://www-sciencedirect-com.lehman.ezproxy.cuny.edu/science/article/pii/S0302283806005264

Jensen, G. A., Zhiyuan Zhou, & Yasuhiro Torigoe. (2003). Medical care of overactive bladder in elderly patients. Journal of Aging & Pharmacotherapy, 13(1), 13–27. Retrieved from http://web.b.ebscohost.com.lehman.ezproxy.cuny.edu/ehost/pdfviewer/pdfviewer?vid=1&sid=f1a806f5-f021-4da9-ae84-706797e2a0bd%40pdc-v-sessmgr06

Theile, G., Kruschinski, C., Buck, M., Muller, C. A., & Hummers-Pradier, E. (2011). Home visits - central to primary care, tradition or an obligation? A qualitative study. BMC Family Practice, 12, 24. Retrieved from https://link-gale-com.lehman.ezproxy.cuny.edu/apps/doc/A256892103/CWI?u=lehman_main&sid=CWI&xid=a71d1edf