Vulnerable Patients Participating In Healthcare Research

Critically analyze the ways in which researchers can minimize harm to vulnerable patients participating in healthcare research

Vulnerable Patients Participating In Healthcare Research

Health research is the multidisciplinary field of scientific investigation that studies how social factors, financing systems, organizational structures and processes, health technologies, and personal behaviors affect access to healthcare, the quality and cost of healthcare, and ultimately our health and well-being. Its research domains are individuals, families, organizations, institutions, communities, and populations. (Keeler, 2007, 337-67 )

The definition of healhcare research has changed and evolved over time reflecting the capacity of the field to address the increasingly complex array of Health, the role of preventive as well as curative services, and the impact of services on both individuals and populations. In 2009, a National Academy of Sciences, Institute of Medicine (IOM) report titled Health Research: A Report of a Study stated: “Health research is inquiry to produce knowledge about the structure, processes, or effects of personal Health” (p. 14). The early and current definitions substantially overlap. The earlier definition was understandable to researchers who produced healhcare research but likely not very understandable to the wide range of healhcare research users and the public. The current definition should be clearer to users of healhcare research and is more encompassing, recognizing the importance of social factors and personal behaviors on the use of Health and health outcomes. The definition identifies specific characteristics of the Health that are of particular importance, including access to care, quality, cost, and their contribution to health and well-being outcomes. These characteristics are to be examined and understood for individuals and for populations. The linkage of individual and population health forms an explicit bridge between medicine and public health and between health service interventions at both the individual and population or community levels. These changes in the definition document the changing vision for healhcare research and for Health. Keeler

2007

337-67

Rising and difficult to control, healthcare costs have been a persistent public policy issue since the passage of the Medicare and Medicaid programs in 1965. Health economists have contributed to the understanding of the complexity of forces driving healthcare costs, including the lack of cost competition among providers, the design of health insurance plans in a way that protects individuals from having to make economic choices (moral hazard), and failures to provide consumers with information on cost and quality trade-offs. The classic RAND Health Insurance Experiment (HIE) of the 1970s demonstrated that increasing the level of out-of-pocket payments (coinsurance and deductibles) for healthcare reduces the average use of Health and costs. An analysis of episodes of care by Keeler and Rolph showed that the level of out-of-pocket payments was a primary influence on the decision whether or not to seek healthcare. Once the decision to seek healthcare was made, coinsurance and deductibles had little effect on the cost of the episode of treatment. One interpretation of this finding was that once the vulnerable patient was receiving healthcare, the physician and not ...