The Impact Of Gatekeeping On Health Care Systems Essay

Gatekeeping is a concept that is often applied to health care systems. This disquisition will discuss in depth the role of gatekeeping in health care systems. The key aspects discussed will be gatekeeping and, how it operates in the New Zealand (NZ) health system. Along side that another key aspect that will be explored is the absence of gatekeeping systems in countries such as, the United States of America (USA). And, how this effects the primary and specialist care sectors of the health care system in that country. In addition to gatekeeping systems, this disquisition will also comprehensively compare and contrast a few of the repercussions of having a gatekeeping system as well as the repercussions that arise from the absence of one. Gatekeeping can be defined as, the ability of a primary health care professional to authorize or restrict the access of a patient to specialists, hospitals and other such medical facilities that require primary care physician (PCP) referral (Bodenheimer and Grumbach, 2009). Thus, a patient can only gain access to secondary or tertiary care if they have initially been referred by their PCP. The purpose of gatekeeping in a health care system is to control the number of laboratory tests, therapist as well as specialist referrals (Malcolm, 2004). Gatekeeping occurs predominantly in the primary care sector of the health care system and, the gatekeepers generally tend to be the primary care physicians or qualified nurse practitioners (Cummings,Show MoreRelatedWhat Are Primary Care And The Related Concept Of Gatekeeping?1422 Words   |  6 PagesWhat are primary care and the related concept of gatekeeping? How does that model work for the United States health care delivery system? The utilization of primary care physicians as gatekeepers to masters and other medical resources, thought to be an overseen care development in the United States, has multiplied amid the previous couple of decades. Its presentation has been joined by a legislature supported developer of research into referrals from primary care. †¢ Gatekeeping systems have developedRead MoreThe New Zealand Health System Essay1648 Words   |  7 PagesHealth is a complicated concept, and the needs and desires of patients are unique and individual. A national health system needs to meet these desires in the most specific way possible to ensure the best health outcomes for the most people. The goals of the New Zealand health system, as specified in the New Zealand Health Strategy by King in 2000, include providing service that will lead to improved health for all New Zealanders and identified coordination and collaboration between sectors as a majorRead MoreHealth Care Field Cost Control Methods Essay846 Words   |  4 PagesMy homework is entirely my own work and I did not copy from anyone else. It is very important that we utilize cost control methods in the health care field. The reason being is that about 10% of the population, usually with chronic to severe problems, use approximately 70% of the total spending (Shi, Singh, 2008). If we didn’t monitor the costs and spending we wouldn’t be using the money efficiently. To avoid potential problems we frequently use six different cost control methods to monitorRead MoreThe Complex And Historical Problem Accessibility1306 Words   |  6 Pagesyet daunting, task of instituting a successful healthcare system. This is exceedingly difficult as each country is unique in their history, culture, population and health needs, all of which require a specialized system. Furthermore, an ideal system addresses equally the three key aspects of healthcare: quality, affordability and availability. A system without even one of these aspects at its full potential is not providing the best care possible for the population. Arguably, accessibility is theRead MoreU.s. Health Systems And Perspectives1601 Words   |  7 Pages HEA 201 Health Systems and Perspectives Midterm Exam Directions Carefully read and respond to each question. Please complete your responses using complete sentences. Your responses will be evaluated on the basis of content accuracy, clarity, correct usage of the English language, and demonstrated evidence of critical analysis. Each question is valued at 5 points. Total Possible Points = 100 1. What are 6 basic characteristics that differentiate the U.S. health care delivery systemRead MoreReflection Paper On Health Care Delivery1489 Words   |  6 Pages Reflection Paper Introduction: Health care delivery in America has a unique approach. I worked as a Dentist in India and gradually developed an interest in Health Care Administration, which is why I have selected MHA to pursue my career as a manager or administrator in a health care setting. Eventually, I did some research on scope and importance of managers in Health Care settings. Consequently, I have found that U.S Health Care model has been followed and recognized globally.Read MoreHealth Care For Transgender Patients Essay1918 Words   |  8 PagesRegarding access to healthcare, transgender individuals often face the most obstructive barriers when attempting to receive care. Whether they are seeking access to hormones, therapy, general health services, reproductive healthcare, or specialty healthcare, transgender patients typically cannot get what they need without jumping through many hoops or hiding their identities. This occurs especially so in cases of intersecting identities -- where an individual is n ot just transgender, but is transgenderRead MoreEssay about Managed Care3307 Words   |  14 PagesManaged Care   Ã‚  Ã‚  Ã‚  Ã‚  There are so many problems with our society’s health care. Everyone wants to find a solution, but no one has been able to come up with one yet. Many different things have been tried, but none have put a cease to the exorbitant costs, which most believe to be the main problem. Out of everything tried, the most recent and popular system is known as managed care. Managed care is the most common form of health insurance in the United States, and provides moreRead MoreChild Custody Evaluation Essay2370 Words   |  10 Pagescases are referred to court-appointed mental health experts during the process. Patel and Jones state that mental health counselors possess the knowledge and skills to be effective mental health evaluators in child custody disputes. However, these counselors must be able familiar with guiding principles and standards that are in the area they are in. Thus, a counselor must not only know the standards of the counseling profession American Mental Health Counseling Associate and American CounselingRead MoreSymptoms And Treatment Of Elderly Patients1781 Words   |  8 Pagesthe same standard of treatments and care, as compared to younger patients. Elderly patients are also reported to be less likely to receive surgery and the most effective treatment than younger people irrespective of the co-morbidities. This is because healthcare professionals tend to make decisions based on the assumptions that older patients will not be able to cope with certain treatments without fully accessing their overall health status. (Department of Health, 2010) As survival rate for p atients

Night Creature Hunter’s Moon Chapter 36 Free Essays

I wanted to ask what Edward had said. I hoped he wasn’t coming to shoot me. If I had to go, I wanted Jessie to do it, not Edward. We will write a custom essay sample on Night Creature: Hunter’s Moon Chapter 36 or any similar topic only for you Order Now He seemed so frail lately. My dying would not help. My dying by his hand would certainly hurt. I wanted to ask, but I never got the chance. As we sat down to formulate some kind of plan, the room suddenly went dark and cool. I heard the trees rustle, even though the windows and the doors were shut. I smelled leaves, evergreens. I was hungry. Starving. My belly growled, or maybe the sound came from my mouth. I wasn’t sure. I had to eat or the hunger would consume me. The madness flickered at the edge of my brain. Food. Blood. Meat. Dimly I felt myself slide from the couch to the floor. Damien was there, lifting me, carrying me to the bed. I turned my mouth toward his neck, but he smelled like wolf, not man. I scented fresh meat nearby. My gaze went to Jessie. She narrowed her eyes. â€Å"Don’t even think about it.† But I did. The hunger was a living, breathing, aching thing in my stomach. I half-expected it to burst out and devour everyone near me. I placed my hands over my middle and moaned. But the sound that came out of my mouth was something else entirely. I understood how the hunger caused sane men to go mad. I was a little crazed myself. Then the fever ripped through my body; like a fire it blazed. My skin burned, my scalp tingled, and darkness cloaked my mind. I awoke in the woods – naked, alone, covered in blood. My hunger was gone, my belly distended. The sun was rising in the east. I had no idea where I was. I remembered nothing of what I had done. And I didn’t care. That was the strange part. I’d in all likelihood killed, then eaten, my friends, maybe even my lover – though I doubted Damien would have stood still and let me devour him. Literally, anyway. But now that the hunger was appeased, all I cared about was making sure that the next time it came I had plenty of people to hunt. I ran through the forest, felt the breeze on my skin, through my hair. I reveled in the dirt beneath my feet. I jumped into a river and washed the blood away, then lay in the sun and let the water drip from my body into the earth. The remnants dried in the heat, and I drifted to sleep. When I awoke again, someone was pressed spoonlike against my back. I turned and found Hector, naked like me and aroused. He kissed me and as he did, we both changed. I sat bolt upright in bed. Or at least I tried. Someone had tied me down. Again. I was sweating, shaking, crying, but I wasn’t in the woods. Obviously I never had been. â€Å"What happened?† I fell back on the pillow, turned my head. Jessie sat in a chair. â€Å"Kill me,† I rasped. â€Å"Promise.† â€Å"I already did.† I closed my eyes. â€Å"It’s awful, Jessie. I don’t want to be like that.† â€Å"I know.† We sat together, silent. I kept my eyes closed until I stopped seeing myself in the woods, with Hector, stopped tasting†¦ horrible things, stopped hearing screams that had never truly happened. At least not yet. â€Å"Where are the boys?† I asked. â€Å"Gone.† â€Å"What?† I tried to sit up again. The bonds scraped along my already-raw wrists and ankles. â€Å"You didn’t let them go after Hector. He’ll eat – â€Å" I stopped. â€Å"Eat them alive† had once been an expression; now it was reality. â€Å"They aren’t hunting. They went to pick up Elise and Mandenauer.† â€Å"But they shouldn’t be alone.† â€Å"Someone had to go, and I thought it was best if I stay.† She left unspoken the reason why. Damien wouldn’t kill me. Will probably couldn’t. I wanted to stay awake, but the virus made me weak. The fever made me toss and turn. The changes made me ache. My back burned, which wasn’t new. However, my bones were doing something weird. Snapping, popping, shifting. My eyes hurt. My nose tickled. My teeth seemed too big for my mouth. I fell back into the void where Hector waited. My dreams, fantasies, or whatever the hell they were remained pretty much the same. Blood, death. A little bit of doggie-style sex. I awoke to a silver sheen drifting through the windows and across my bed. The moon was cool. It soothed the fever, calmed my racing heart, called me to come and dance in its light, naked and alive. Murmurs on the porch. My ears tuned in. I could hear everything they said. â€Å"This could kill her.† I recognized the voice of Dr. Elise Hanover. â€Å"We haven’t tested the serum yet.† I’d never seen the woman, only spoken to her on the phone. I couldn’t see her now, except for a slim shadow among all the other shadows clumping together on the porch. â€Å"We will test it now.† That was Edward, always calm, in control, regardless of the situation. â€Å"I won’t let you kill her on the off chance you might save her,† Damien insisted. â€Å"You have nothing to say about it.† â€Å"I do!† I called. The group went silent and still, then filed into the room. â€Å"The gang’s all here,† I murmured. Jessie, Will, Edward, Elise, and Damien hovered near the door, as if afraid to come near me. I didn’t want to know why. Elise was the first to move. She clipped across the wood floor wearing heels the shade of fine porcelain. Her stockings were sheer. Her suit a pure sea green. She could have been a model – tall, bone thin, with platinum hair that would be long if she ever released the tight coil cemented to the back of her head. Her skin matched her shoes; her eyes were dark blue, nearly violet. There wasn’t a flaw on her face. And she had a Ph.D., too. Life was hardly fair. â€Å"I’ve invented a serum,† she said. Her voice was as lovely as she was – low, husky, far too sexy for a scientist. Every man in the room, except for Edward, stared at her with his mouth open. â€Å"However, I don’t know if it works.† â€Å"So I heard.† They all exchanged glances. If I’d been able to hear them whispering on the porch, the change had already begun. Behind Elise’s back, Jessie made a face and rolled her eyes. Dr. Hanover was too perfect for words. We had to hate her. It was a matter of pride. â€Å"The choice is up to you, Leigh.† I turned my gaze to Edward. He appeared older, sadder, quite tired. I wondered what he’d been doing while he’d been away, but I didn’t have time to ask. My body bowed. My spine seemed to be cracking in two. I opened my mouth to cry out, and a howl escaped instead. When the pain went away and the echo of the howl faded, I glanced at everyone, only to find them studying the ceiling. Except for Damien. He shook his head. I held his eyes as I said, â€Å"Do it, Doctor.† â€Å"Wait!† he blurted. â€Å"No.† â€Å"Let me talk to her before – â€Å" â€Å"Damien,† I interrupted. â€Å"I know what you want to say.† He loved me. I loved him, too. But I wasn’t going to tell him. He’d only agonize longer if I died. I wasn’t going to tell anyone what he was, either, even if it went against every vow I’d ever made, every oath I’d ever taken. I couldn’t sentence him to death, even if he wanted me to. â€Å"I don’t think you do know,† he continued. â€Å"Everyone get out.† â€Å"Just one minute, young man – † Edward began. â€Å"Get out!† Damien shouted. Edward’s eyes narrowed, but Jessie took his arm and Will took Elise’s. â€Å"One minute,† Jessie said. â€Å"No more.† The door closed, and Damien was at my side; his fingers tugged on the knots of the rope. â€Å"What are you doing?† â€Å"Let’s get out of here.† â€Å"What? No. Are you crazy?† He let go of the knots, cupped my face in both his hands, and kissed me. I barely had a taste of him before he lifted his mouth and stared into my eyes. â€Å"Run away with me. Be my mate. In my mind you already are.† â€Å"We can’t hide from them forever.† â€Å"I’ve been hiding from them for fifty years.† True, but I couldn’t spend my life running. Not even for him. â€Å"Damien – â€Å" â€Å"We’ll be together.† His voice held a desperate edge. â€Å"You’ll be like me.† â€Å"But I won’t be like you. I’ll be evil.† â€Å"I don’t care.† â€Å"Yes, you do. And so do I.† Damien let me go, ran his fingers through his already-tousled hair. â€Å"I remember how intense the hunger is at first, but it gets better.† â€Å"Only because I’ll forget what it was like to be human.† He didn’t answer, because I was right. Edward came in. His eyes went to the ropes, narrowed; then he crossed the room and tightened the bonds. He ignored Damien as if he weren’t even there, sitting in the chair beside me and patting my head like a pet. Damien inched away to hover near the kitchenette. â€Å"Liebchen,† Edward murmured. â€Å"I am sorry.† â€Å"Don’t be. My fault.† â€Å"I got you into this.† â€Å"I wanted to be into this.† â€Å"I know.† His eyes slid toward Damien, and he lowered his voice to a whisper. â€Å"You asked me if he was a rogue agent. Why?† I didn’t want to explain†¦ anything now. â€Å"Later, Edward.† It was an indication of how much he cared for me that he didn’t press the issue. â€Å"If I’d realized you were involved with him I’d have checked him out more thoroughly.† â€Å"Jessie ran him through her system.† â€Å"I have a much better system.† He did. I glanced at Damien. He could hear everything we said, but Edward didn’t know that. Damien would have to disappear when this was over. Once Edward ran his name through the system, he’d learn more than was healthy for both of them. â€Å"I never thought to see you with a companion,† Edward murmured. â€Å"Why this one?† Why Damien? I had no idea. Maybe it was the sadness in him that called to the sadness in me. Maybe it was a secret fascination with the monster. Frankenstein complex? Dracula delusions? Werewolf syndrome? At least Damien wouldn’t die as easily as everyone else I’d ever loved. Hell, maybe it was just the incredible sex. But, in truth, I felt so much more for Damien than lust. â€Å"Take care of him,† I whispered. â€Å"If I can’t.† Edward’s eyes widened. â€Å"Promise,† I insisted. â€Å"Whatever you wish.† He squeezed my bound hand. â€Å"Leigh, you should have told me your nightmare was back. I would have killed him for you, gladly.† â€Å"I know.† The others came into the room. Elise crossed to the kitchen table, where an old-fashioned medical bag rested. She rustled around inside. â€Å"Is this why you had to stay at headquarters?† Edward hesitated an instant, then nodded. â€Å"It is the first breakthrough we’ve had.† â€Å"You said she hadn’t found anything.† â€Å"I was wrong. Or I hope that I was. Elise wanted to test the serum further, but we have no time.† â€Å"Let Elise do her thing.† Edward nodded, then patted me again and moved away. He had never been very good with emotion, even worse with affection. Sometimes I wondered what he’d been like before the war. Elise swabbed my arm. I resisted the urge to sneer. An infection couldn’t hurt me now. The others crept up behind her, as if they couldn’t make themselves stay away. â€Å"You understand I haven’t tried the serum on anyone yet?† â€Å"I got that. What’s the recipe?† â€Å"Little bit of this, little bit of that.† She walked back to her bag. â€Å"I need the blood of a live werewolf, in human form.† I frowned. â€Å"But how – ?† Damien’s arm shot out. â€Å"Use mine.† How to cite Night Creature: Hunter’s Moon Chapter 36, Essay examples

Manifest Destiny vs. Imperalism free essay sample

Manifest Destiny is imperialism covered up with the word of God, is gives people the right to steal from Native Americans. The US was not  imperialistic  though they had some of the same attributes as imperialistic nations. They did not have the strong desire to dominate other nations, and create colonies on other continents. They were expanding across unexplored lands. Since they owned the land they should take it, and use it. They made a lot of mistakes at high cost to the natives. There were many instances that Native Americans were tortured and taken from their home lands such as the trail of tears. These instances did not make America imperialistic just for this time period it was exemplifying some of its characteristics. Imperialism isn’t always the best way to go about obtaining land. For example, William Walker tried to grab Nicaragua and claim it for himself. He was a self proclaimed president of that nation. We will write a custom essay sample on Manifest Destiny vs. Imperalism or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page He immediately made slavery legal and installed unjust laws by the wave of his hand. Eventually Central American forces aligned to take out this imperialistic monster and he was taken out of office almost instantly. William Walker is a good example how full blown imperialism cannot work in society and how Americans will never let any of its ideals ever come into power until they reason that â€Å"God† sent them to do his work. The question they should have asked themselves is â€Å"Do I really know what God wants? † The US began as a colony of Britain, but it sought independence, and separated itself from Britain. The US started as imperialistic, but changed into nationalistic. In the US, the settlers were treated as citizens, they created states, and they were treated like the rest of the original colonies. So imperialism is when a powerful country puts a colony in an inferior country for land and raw materials. What happened in the US was unique, because it was a colony from an imperialistic nation that defected, became nationalistic, and then they expanded into land that they legally owned at the cost of the natives. Although American immigrants thought they were sent from â€Å"God† to develop the lands bought from Spain they were mistaken. The imperialistic mind set that they had developed was centered on a belief that someone you could not hear, see or touch told you that you could steal lands from innocent people. You could also kill anyone in your way to a successful future; this is imperialism it is just covered up with fancy words like Manifest Destiny.