COMPETENCY

Identify the challenges and opportunities facing health care.NON_

PERFORMANCE:

Does not identify an aspect of a local or regional health care system or program that should be a focus forchange.

BASIC:

Identifies an aspect of a local or regional health care system or program that should be a focus for change,but the rationale for the choice is unclear.

PROFICIENT:

Identifies an aspect of a local or regional health care system or program that should be a focus for change.DISTINGUISHED:Identifies an aspect of a local or regional health care system or program that should be a focus for change.Provides clear expectations for improvements substantiated by credible evidence.

Comments:

Identifies an aspect of a local or regional health care system or program that should be a focus for change.The global prevalence of diabetes, particularly Type 2 Diabetes Mellitus (T2DM), has increased rapidly over the last three decades (Ali et al., 2017). This increase is noted in the U.S. and other regions, including the Middle East and North Africa (MENA) countries. This report compares and discusses clinical interventions used by the U.S. and MENA regions to address the current increase in the T2DM prevalence.The rising global rates of diabetes are adversely affecting people’s life expectancy and resulting in economic burdens. In the U.S., around 10.5% of the population has diabetes (CDC, 2020).

Despite the government and other private organizations’ efforts during the last three decades in introducing different prevention interventions, about 88 million Americans still have prediabetes and unaware of their conditions(CDC, 2020). This increases the risk of prediabetes progressing to T2DM.The proposed change is to lessen the economic burden and improve patients’ quality of life with T2DM.According to Ali et al. (2017), structured diabetes self-management education (DSME) programs and self-monitoring of A1C levels are cost-effective and practical, respectively, to prevent, detect, and control diabetes.

Scoring guide.capella.edu/grading-web/gradingdetails3/15Could you describe the effectiveness of one of these DSME programs??

Define desirable outcomes, including who will pay for care and factors limiting achievementof those outcomes.

COMPETENCY Compare the effects of different health care finance models and policy frameworks on resources and patientoutcomes.

NON_PERFORMANCE:Does not define desirable outcomes.

BASIC: Defines desirable outcomes, without including responsible payer or limiting factors.

PROFICIENT:Defines desirable outcomes, including who will pay for care and factors limiting achievement of those outcomes.

DISTINGUISHED:Defines desirable outcomes, including who will pay for care and factors limiting achievement of those outcomes. Provides well-reasoned justification for the definition and exhibits insight into optimal health care solutions.Comments:

The desired outcome is to reduce the rates of T2DM in the future. An A1C level of prediabetes ranges between 5.7% and 6.4%, while T2DM from 6.5% and above (CDC, 2020). Since T2DM patients are at a higher risk of cardiovascular diseases such as stroke and heart attack, the primary goal is to prevent their cardiovascular mortality and morbidity rates. Though reducing T2DM rates through these interventions may seem manageable, two primary challenges can hinder these outcomes’ success.

One of these barriers is a lack of patient motivation. Patient motivation helpsin initiating the relevant changes in patients’ lifestyles. These lifestyle changes include patients engaging in exercises, eating a healthy balanced diet, self-management through medications, and performing frequent foot, eye, and HgbA1C tests. Most T2DM patients who adhere to these lifestyle changes portray a decline in their A1C levels to prediabetes (Ali et al., 2017). The second barrier is the lack of governmental support for the uninsured.

In the U.S., most of the total costs of diabetes care of 67.3% are catered for by government insurance, including Medicaid, Medicare, and the military (ADA, 2021). The rest (30.7%) is paid by private insurance or uninsured (2%). Government insurance does not cover all the costs of the uninsured. Uninsured

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Diabetic patients often have fewer office visits and medications, which results in the progress of prediabetes toT2DM (ADA, 2021).

 CRITERIA 3 Explain why specific changes will lead to improved outcomes.

COMPETENCY Develop proactive strategies to change the culture of the organization by incorporating evidence-based practices.

NON_PERFORMANCE: Does not describe expected improvements in outcomes.

BASIC:Describes expected improvements in outcomes, or provides no rationale for expectations of improved outcomes

PROFICIENT: Explains why specific changes will lead to improved outcomes.

DISTINGUISHED:Explains why specific changes will lead to improved outcomes. Draws well-substantiated conclusions tha tare in line with reasonable expectations.

Comments: Explains why specific changes will lead to improved outcomes. DSME programs and self-monitoring initiatives aim to help people have healthy body weight. With weight reduction, T2DM patients can reduce their A1clevels to the prediabetic range (Ali et al., 2017).

These interventions tailored to the goals and culture of the patient population can significantly assist the healthcare system. For efficient initiation of the interventions, it will be crucial for the CMS to continue offering incentives for staff motivation and to promote sustainable reduction of diabetic outcomes in the future.

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CRITERIA 4  Analyze two non-U.S. health care systems or programs that offer insight into a proposed change for a health care system or program in the United States.

COMPETENCY Compare the effects of different health care finance models and policy frameworks on resources and patient outcomes.

NON_PERFORMANCE: Does not analyze two non-U.S. health care systems or programs that offer insight into a proposed change for a health care system or program in the United States.BASIC:Analyzes two non-U.S. health care systems or programs, but relevant connections to the U.S. system are tenuous.

PROFICIENT:Analyzes two non-U.S. health care systems or programs that offer insight into a proposed change for a health care system or program in the United States.

DISTINGUISHED:Analyzes two non-U.S. health care systems or programs that offer insight into a proposed change for a health care system or program in the United States. Articulates insightful lessons learned from the analysis that have clear implications for U.S. health care.

Comments: Analyzes two non-U.S. health care systems or programs that offer insight into a proposed change for a healthcare system or program in the United States The prevalence of T2DM in the MENA region is the second-highest in the world. This rate has escalated over the past three decades. This high prevalence is primarily associated with obesity. Currently, 38.7 million individuals in the MENA region have diabetes, with the number expected to escalate to 112% by 2045 (Huang et al., 2017).In North Africa, the regional prevalence of adults diagnosed with diabetes is 9.2% (Huang et al., 2017).

The rising prevalence of T2DM in the region has resulted in more individuals seeking diabetic care, with the government being unable to cater to most of their medication and supplies. For instance, in Sudan, its government spends $175 per year in the care of every individual diagnosed with diabetes (Mapa-Tassou et al.,2019).

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In the Middle East, the regional prevalence of adults diagnosed with diabetes is around 9.2% (Huang et al.,2017). Most factors contributing to this increase can be modified, including urbanization, physical inactivity due to more low physically demanding occupations, and unhealthy dietary habits. Diabetes prevalence in the urban regions is high compared to the rural areas due to lifestyle changes such as eating habits.

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CRITERIA 5 Determine the financial and health implications of making—and not making—proposed changes to a health care system or program.

COMPETENCY Evaluate the positive and negative influences of leaders on health care processes and outcomes.

NON_PERFORMANCE:Does not determine the financial and health implications of making—and not making—proposed changes to a health care system or program.BASIC: Determines the effects of proposed changes, but overlooks key financial and health implications.

PROFICIENT:Determines the financial and health implications of making—and not making—proposed changes to a health care system or program.

DISTINGUISHED:Determines the financial and health implications of making—and not making—proposed changes to a healthcare system or program. Draws insightful, well-reasoned conclusions based on credible evidence.

Comments:Determines the financial implications associated with the proposed changes to a health care system or program. According to the ADA (2021), the costs of diabetic care in the U.S. “have risen to $327 billion in 2017from $245 billion in 2012.” Therefore, it is paramount for the government to support initiatives that can increase these interventions to prevent prediabetic individuals from progressing to T2DM. This will save funds spent on managing T2DM and its complications. Nonetheless, suppose the U.S. government does not increase interventions to address the current rising T2DM rates. In that case, the total medical expenses of diabetic individuals will escalate to over $500 billion per year in the next ten years.

What about the health implications of the proposed changes? Please address the implications of making the changes and not making the changes. What are the likely costs and benefits for individuals and the community at large? What are the potential short and long term effects?