Health Care Disparities: Interview Case Study
There are approximately 200 accredited birth centers across the United States that provide a beginning infrastructure for making childbearing centers the frontline of maternity care (Mason, Leavitt, & Chafee, 2012). These centers have been shown to be cost effective and unique in the way that, without disparity, they are able to offer safe, high quality, family centered care to individuals. Recently, while the American College of Obstetrics and Gynecologists (ACOG) have shown support to these accredited birthing centers, they still show resistance to programs, such as these, that veer away from organized medicine. These facilities are being threatened by lack of funding and lack of providers available to fill the roles that many individuals require. This paper will explore an interview with maternal health expert and health model pioneer Ruth Watson Lubic, EdD, CNM, which outline the disparities faced by these institutions. Feasible strategies to expand the role and opportunity for nurses to address the primary care supply and demand gap will also be reviewed. Finally, the role that nurses take in advocacy for much needed health care policy and reform to address these disparities will also be discussed, in order to promote becoming more visible and influential within this infrastructure.
In the article outlining the interview of Ruth Watson Lubic, EdD, CNM, race, income, and education are some of many of the disparities discussed that her patients are faced when receiving maternal healthcare in a hospital setting. This interview discusses how these issues are bridged and reduced in the new models of care offered by her childbearing centers, whose goals are to provide high quality, safer, patient and family centered care to every individual, regardless of their ethnicity, income, or insurance carrier. Common disparities are not determining factors for care at these clinics. The model of care designed for these centers is good for any family. Focus is not on the individual’s financial status. For example, instead of just focusing on low income minority groups, Dr. Lubic realizes that the need for personalized, supportive, empowering maternity services is just as great in the white, high income individual or family. By empowering the individual to be interactive in their care, and in control of her choices while giving birth, allowing for cultural influence, and to having family members included as well, these clinics have increased the interest in being involved in one’s own care. By meeting patient needs on an individual level, the disparities associated with birth are reduced. For example, in the birth centers opened by Dr. Lubic, the breastfeeding rate is 100% (Mason, Leavitt, & Chafee, 2012). In contrast, the overall breastfeeding rate in Washington D.C. is 73.7% (CDC, 2012). Additionally, the amount of babies who were born at these birth centers that needed neonatal intensive care unit (NICU) care, when compared to the number of births with area hospitals, was greatly reduced in the maternal birth centers. Dr. Lubic’s facilities bridge the disparity gap by offering equal access and treatment to all patients that is not dependent on race, age, income, or education level. A growing problem that has threatened facilities such as these, are the lack of providers available to open more clinics, as well as lack of funding to keep these doors open. Medicaid and Medicare reimbursement is not as dependable in the birth centers as it is when billed by hospitals, even though such births in centers have been shown to save insurance companies 3-4 times the cost as a hospital birth % (Mason, Leavitt, & Chafee, 2012). Lacks of providers for these patients, and lack of funding to keep these doors open, are just the disparities that keep these patients from having access to safer and equal treatment. To keep valuable clinics...
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