Answer the questions below based on the following case study.

A 26-year-old woman presented to the clinic after her cleaning rituals had so exhausted her that she had given up and could now enter only two of the five rooms in her home. For more than a year she has worried that if her house is not sufficiently clean, her 3-year-old son will become ill and could die. Having touched a surface she has to disinfect it repeatedly – a procedure performed in a particular way and taking several hours. In addition, she repetitively washes her hands and sterilizes all the crockery and cutlery before eating. She realizes that she is ‘going over the top’, but she cannot stop thinking that items may have germs on them. This leads to disabling anxiety and fear for her son’s health, which she can only resolve by cleaning. This helps temporarily, but soon the thoughts return again.

1. Summarize the clinical case.
2. What is the DSM 5-TR diagnosis based on the information provided in the case?
3. Which pharmacological treatment would you prescribe according to the clinical guidelines? Include the rationale for this treatment.
4. Which non-pharmacological treatment would you prescribe according to the clinical guidelines? Include the rationale for this treatment excluding a psychotherapeutic modality.
5. Include an assessment of the treatment’s appropriateness, cost, effectiveness, safety, and potential for patient adherence to the chosen medication. Use a local pharmacy to research the cost of the medication and provide the most cost-effective choice for the patient. Use great detail when answering questions 3-5.

Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in the current APA style with support from at least 2 academic sources.  Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) 
• All replies must be constructive and use literature where possible.
• Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
• Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.
• You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.

  

Respond at least 2 times each . The goal is for the discussion forum to function as robust clinical conferences on the patients. Provide a response to 1 of the 3 discussion prompts that your colleagues provided in their video presentations. You may also provide additional information, alternative points of view, research to support treatment, or patient education strategies you might use with the relevant patient.

2-3 pages APA scholarly articles family disaster plan for a tornado

Maria Hernandez

Main Post:

H.R. 977- Patient Access to Higher Quality Health Care Act of 2023.

 

Description: When a patient has health insurance, depending on which premium, they are made to use providers or hospitals that are “in-network” to avoid higher costs of services. This can often be an issue for patients because some providers are not in network with their health insurance, specifically Medicare recipients. The Patient Access to Higher Quality Health Care Act would “repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals” (Congress.gov, 2023).

Background: According to the American Hospital Association, “For decades, the Ethics in Patient Referrals Act (“Stark Law”) has protected the Medicare program from the inherent conflict of interest created when physicians self-refer their patients to facilities and services in which they have a financial stake” (AHA, n.d.). At one point, physicians were allowed to make referrals to hospitals with ownership within the entire facility; this gap was closed in 2010 when the Affordable Care Act was passed.  

Social Determinant: One social determinant is access to health care and quality care. Patients, regardless of their socioeconomic status, should receive high-quality care. The American Hospital Association states, “The Government Accountability Office (GAO), the Centers for Medicare & Medicaid Services and MedPAC all found that physician-owned hospitals’ patients tend to be healthier than patients with the same diagnoses at general hospitals” (AHA, n.d.). This would lead those with serious illnesses to rely on general hospitals for healthcare services.

Evidence: The growth of Physician-owned hospitals was prohibited in 2010 after the passing of the Affordable Care Act. According to Ehrenfeld, “a systematic review of 30 years of research demonstrating that physician-owned specialty hospitals or so-called “focused factories” offer higher-quality care at comparable or lower cost, while physician-owned community hospitals are no worse than their counterparts” (Ehrenfeld, 2023). If H.R. 977 is passed into law, it would allow physicians of physician-owned hospitals to extend their services to the community by opening new hospitals that would provide high-quality, efficient care and be affordable to patients. This would place competition against general hospitals at risk of losing market share, leading them to reform their services to stay in competition. This would benefit patients in being able to seek assistance in a variety of hospital or hospital-owned facilities. 

 

References:

American Hospital Association. (n.d.). Fact sheet: Physician self-referral to physician-owned hospitals. https://www.aha.org/fact-sheets/2023-02-27-fact-sheet-physician-self-referral-physician-owned-hospitals

Congress.gov. (n.d.). H.R.977 – 118th Congress (2023-2024): Patient Access to Higher Quality Health Care Act of 2023. https://www.congress.gov/bill/118th-congress/house-bill/977?q=%7B%22search%22%3A%5B%22HR+977%22%5D%7D&s=1&r=1

Ehrenfeld, J. M. (2023, August 10). End restrictions on physician-owned hospitals to expand Quality Care. American Medical Association. https://www.ama-assn.org/about/leadership/end-restrictions-physician-owned-hospitals-expand-quality-care