Leadership Decision Making Health Economics Question And Answer

Introduction Of Leadership Decision Making Health Economics Question And Answer

This assessment aims to explore the application of health economics and the principle of authentic leadership in reference to a chosen case scenario. The term “health economics” refers to the field of study focusing on allocating healthcare resources, including the costs, efficiency, and effectiveness of healthcare services (Cohen & Flood, 2022). For this proposed assessment, the article by Maru et al., (2018) has to be taken into consideration for analysing ‘health economies’ and ‘importance of authentic leadership’ in the complex healthcare environment.

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Criteria 1: Components of health economics

Health economics is one of the many disciplines that can be used to analyse health and healthcare issues, specifically as one of the sets of analytical methods in Health Services Research. According to the research by Barbu (2023), health economics is the application of economic theory, models, and techniques which analyse the decision-making by individuals governments, and healthcare providers concerning health care. As per the article by Maru et al., (2018), addresses the key components of health economics particularly in the context of economic evaluation of secondary prevention program used to prevent the chronic heart Failure in high-risk individuals. In the chosen article health economies involve calculating the cost in relation to the medical intervention including medical cost and indirect cost. On the other hand, QALYs is another key component of health economics that combines both quantity and quality of life (Wichmann et al., 2017). As per the article, QALYs provide insight into whether the intervention can improve the patient outcome and can add value to the relative costs. ICER is a key metric in health economics which helps in determining whether the additional cost of intervention is beneficial or not. In the article, ICER was used to compare the nurse-led intervention to standard care in terms of health outcomes and costs related to the services (Maru et al., 2018). So, as a whole, it can be stated that health economies are an important factor in nursing as it guides resource allocation, and ensure cost-effective delivery of healthcare services while maintaining patient outcomes. 

In any healthcare setting, nurses play an important role in delivering cost-effective interventions like prevention programs, which can reduce the hospital admission rate and progression of chronic illness (Faessler et al., 2023). Therefore, by understanding health economics, nurses can advocate for the effective use of healthcare resources, improve access to essential services, and contribute to managing financial sustainability.

Criteria 2: Critical appraisal of study (Refer Appendix 1 for casp table)

Q1: Was a well-defined question posed?

The study by Wu et al., (2024) evaluates the cost-effectiveness of the NIL-CHF, a long-term nurse-led intervention which has been designed to prevent the risk related to chronic heart failure or cardiac dysfunction among high-risk patients. In this study, 611 patients within the age of 66 years with substantial cardiovascular disease have been taken into consideration to analyse that despite a modest reduction in emergency readmission and healthcare cost, the intervention was not cost-effective in terms of QALYs when compared to standard care.

As per the chosen article, the economic perspective in the healthcare system is the costs incurred by the care providers and the impact on the patient outcomes. This study included a comparison between two options, including standard care, and NIL-CHF intervention (Maru et al., 2018).

The time horizon for the economic evaluation is relatively long-term, allowing the author to capture long-term and short-term outcomes associated with chronic heart failure prevention (Zakiyah et al., 2024).

According to this article, though the timely effort to prevent chronic cardiac dysfunction in patients at risk of developing de novo chronic heart failure might be more cost-effective, the Nurse-led Intervention for less Chronic Heart Failure was not shown to be a cost-effective strategy during 3-5 years of follow-up (Maru et al., 2018).

Q2. Was a comprehensive description of the competing alternatives given?

The chosen article has included a trial-based analysis to assess the cost-effectiveness of NIL-CHF intervention versus standard post-discharge care. The NIL-CHF trial was conducted between 2008 to 2013 (Maru et al., 2018). The NIL-CHF group of samples received nurse-led multidisciplinary care with coordinated home-based care and close liaison with community-based healthcare professionals. The group involved in the standard care process was out of any restrictions like discharge planning and post-discharge follow-ups. So, as a whole, in this article, a comprehensive description of the competing alternatives has been given which are: NIL-CHF intervention and standard care.

Q3: Were all important and relevant resources measured in appropriate units and valued credibly?

Upon analysing the given article, I can state that the study has accurately identified and measured all the resources, and health outcomes important to assess the cost-effectiveness of nurse-led intervention to suppress the risk related to chronic heart failure. The key resources that include this study are nursing hours, physician visits, hospital admission, medication, and diagnostic tests with metrics like nursing time and clinic/home visit tracking. In this study, year-of-life gained, and hospitalisation rates have been taken as the metrics to measure health outcomes and effectiveness of intervention (Wu et al., 2024).

Q4: Discuss the applicability of the evidence

Upon analysing the article You et al., (2020), I can state that the NIL-CHF intervention is safe and cost-effective when it comes to reducing the chances of the onset of cardiac dysfunction among high-risk individuals. The article demonstrates that reduction in hospital admission and improved patient outcomes, nurse-led intervention is effective in terms of enhancing patient outcomes and raising patient satisfaction, and the program may provide a cost-effective advantage. However, the sustainability of the process depends on the availability of trained nursing staff and adequate funding. In terms of the applicability of NIL-CHF intervention in the local context, the intervention should comply with the healthcare policies and regulations in the Australian healthcare system.

Criteria 3: Reflection

Q5: Authentic Leadership is grounded in positive psychology and lead productive workplace

As a graduate registered nurse with 12 months of experience in community nursing, my approach to becoming an authentic nurse leader in a complex health environment will be aligned with my commitment to providing patient-centred care and maintaining collaboration and lifelong learning initiatives. During my PEP or Professional Experience Placement, and recent attendance at the Australian Primary Health Care Nurses Association Conference, I gained an in-depth idea about the importance of authentic leadership in a healthcare setting. As per my ideology, authentic leadership encourages self-awareness, rational transparency, and balanced decision-making which can promote a supportive, trustworthy, and collaborative workplace (Baquero, 2023). In a Nurse-led clinic, I would strive to adopt authentic leadership by practising open communication, seeking feedback from colleagues and patients and demonstrating integration and respect to the patient, co-workers and other staff within my workplace setup. Since the outbreak of the pandemic, the healthcare environment has become complex, and in such a scenario, nurse leaders have played an important role in driving changes, improving patient outcomes, and implementing sustainability in the workplace (Kleynhans et al., 2022). As I continue to grow in my role as a nurse leader, I will focus on developing strong relationships with my colleagues, and patients, advocating innovative care models like nurse-led clinics and maintaining authenticity to meet the needs of patients ((Institute for Quality and Efficiency in Health Care, 2015). According to Alilyyani (2022), leadership in complex health environments is not just limited to guiding others to strive for goals, but it also states individuals to be adaptable and maintain straightforward thinking. As an authentic nurse leader, I can support my coworkers in their professional development and encourage them to engage themselves in continuous learning to ensure patient outcomes (Alsiö et al., 2022). The need for leadership in complex health environments can also be evident in the case of nurse-led clinics. These clinics prioritise collaborative work practice and professional growth, and by embracing an authentic leadership approach, I can create an environment where the nurses can empower themselves with the resources required to provide appropriate services to patients. 

So, as a whole, in a complex healthcare environment, the importance of authentic leadership can never be underestimated.

Conclusion

This assessment has highlighted on economic benefits of nurse-led intervention, particularly when it comes to managing chronic heart failure through the NIL-CHF program. In this assessment, highlight has been given on the importance of opportunity cost, cost-effectiveness, and resource allocation in health economies. Additionally, in this assessment, it was mentioned that adopting authentic leadership can foster transparency, ethical decision-making, and improved patient and staff outcomes in healthcare settings.

References

• Alilyyani, B. (2022). The effect of authentic leadership on nurses’ trust in managers and job performance: A cross-sectional study. Nursing Reports, 12(4), 993–1003. https://doi.org/10.3390/nursrep12040095
• Alsiö, Å., Pettersson, A., & Silén, C. (2022). Health Care Leaders’ Perspectives on How Continuous Professional Development Can Be Promoted in a Hospital Organization. Journal of Continuing Education in the Health Professions, 42(3), 159–163. https://doi.org/10.1097/ceh.0000000000000451
• Barbu, L. (2023). Global trends in the scientific research of the health economics: a bibliometric analysis from 1975 to 2022. Health Economics Review, 13, 31. https://doi.org/10.1186/s13561-023-00446-7
• Cohen, D., & Flood, C. (2022). Health economics. In Health Studies: An Introduction (pp. 269-294). Singapore: Springer Singapore.https://link.springer.com/chapter/10.1007/978-981-16-2149-9_9
• Faessler, L., Kofler, S., Wenke‐Zobler, J., Brunner, C., Schäfer‐Keller, P., De Geest, S., Schubert, M., Regez, K., Schuetz, P., Mueller, B., & Conca, A. (2023). The use of nurse‐led care intervention to improve self‐care abilities subsequently decreasing readmission in multimorbid hospitalized patients: A quasi‐experimental study in a real‐world setting. Nursing Open, 10(6). https://doi.org/10.1002/nop2.1637
• Institute for Quality and Efficiency in Health Care. (2015, April 22). Health economic evaluation of medical interventions. Www.ncbi.nlm.nih.gov; Institute for Quality and Efficiency in Health Care (IQWiG). https://www.ncbi.nlm.nih.gov/books/NBK385778/
• Kleynhans, D. J., Heyns, M. M., Stander, M. W., & de Beer, L. T. (2022). Authentic leadership, trust (in the leader), and flourishing: Does precariousness matter? Frontiers in Psychology, 13(798759). https://doi.org/10.3389/fpsyg.2022.798759
• Maru, S., Byrnes, J., Carrington, M. J., Chan, Y.-K., Stewart, S., & Scuffham, P. A. (2018). Economic evaluation of a nurse-led home and clinic-based secondary prevention programme to prevent progressive cardiac dysfunction in high-risk individuals: The Nurse-led Intervention for Less Chronic Heart Failure (NIL-CHF) randomized controlled study. European Journal of Cardiovascular Nursing, 17(5), 439–445. https://doi.org/10.1177/1474515117743979
• Wichmann, A. B., Adang, E. M., Stalmeier, P. F., Kristanti, S., Van den Block, L., Vernooij-Dassen, M. J., & Engels, Y. (2017). The use of Quality-Adjusted Life Years in cost-effectiveness analyses in palliative care: Mapping the debate through an integrative review. Palliative Medicine, 31(4), 306–322. https://doi.org/10.1177/0269216316689652
• Wu, X., Li, Z., Tian, Q., Ji, S., & Zhang, C. (2024). Effectiveness of nurse-led heart failure clinic: A systematic review. International Journal of Nursing Sciences, 11(3). https://doi.org/10.1016/j.ijnss.2024.04.001

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