Essay on how quality of care issues relate to legal, ethical, and financial considerations


According to a study conducted by CDC (2009), between 44, 000 and 98, 000 Americans die each year due to medical errors. Errors in medication alone accounts for approximately 7000 deaths each year, compared to 6000 annual deaths from workplace injuries. The total cost of medical is one of the quality issues in improving quality of care. Consequently, one quality of care initiative is to reduce costs and improve quality of healthcare. Healthcare costs have increased unsustainably over the past two years. The higher cost of healthcare directly translates to high health insurance premiums. In 2003, Medicare paid hospitals only 0. 3 percent of its annual spending on five types of adverse events (CDC, 2009). These extra payments covered less than a third of the costs incurred by hospital in treating these adverse events. As such, healthcare providers transfer the costs to the business community and consumers.

Legal considerations
Healthcare professionals work in a complex environment, with many laws, regulations, and standards of practice. Healthcare professionals face all sorts of legal action against malpractice. Despite the attempts by health care providers to adopt quality improvement strategies, they still lag behind other industries with respect to ensuring safety. The risk of litigation to healthcare professional has forced them to practice defensive medicine, for example performing procedures primarily to ensure that the patient does not allege negligence or error. This limits the ability of healthcare professionals to provide quality care through trial. Another legal issue that relate to quality of service is consent. Some treatments such as surgery require the consent of the patient because performing surgery without proper consent amount to assault (CDC, 2009). These legal factors affect the delivery of quality care. The enactment of health care reform at the federal and state level will bring many structural changes in health care in the coming years. These reforms have focused on expanding access, without addressing the cost drivers of health care. The increased cost of health care will put cost burden on consumers and reduce the quality of care.

Ethical considerations

All health care practitioners are concerned about the potential risk of exposure to situations in their field of practice that could lead to malpractice (Rodriguez, 2009). One of the problems facing the health care system is the lack of mechanisms to adequately control increasing health care cost while issues of American culture that contribute to preventable diseases that are left unaddressed. In America, 30 percent of the increase in health care spending comes from obesity, accounting for $147 billion in treatment (Rodriguez, 2009). When considering the allocation of resources from all sides, it is imperative that focus is not exclusively limited to treatment options, but also allocation of resources to reduce the occurrence of preventable chronic diseases. The allocation of resources requires ethical considerations similar to those that regulate the medical profession (Rodriguez, 2009). These principles do not only guide the micro management of patient care, but also the macro allocation of care within the society. Achieving such initiatives, that benefit the whole society by shifting focus from immediate treatment to reducing diseases, does not only reduce costs but also allow for health care service to the entire population. Application of the same ethical guidelines to macro health delivery system and micro delivery system can enable health care professionals and insurance companies attain the goal of reducing overall cost while offering quality health care.

Financial considerations

Medical care profession in the United States has long been characterized by payment of fee-for-service and a high level of autonomy. Today, patients make arrangements for pay-for-performance to reward hospitals and physicians for adhering to evidence-based standard of care. There is prevalence of pay-for-performance programs in health care contracts with hospitals and physicians. However, there are reports that suggest that pay-for-performance initiatives are not sufficient to motivate significant changes by hospitals and physicians. Ensuring high quality health care service requires a balance of benefits, risks, and preference of patients, rather than adhering to clinical guidelines. Failure to convince medical care professionals that risk adjustment is adequate may motivate them to avoid complicated ailments. This could mean that systems that serve disadvantaged patients may experience diminishing revenues, thereby undermining their safety-net programs.

Impacts of consolidation of health care services on patient care

Consolidation of health care services is a response to changes in the competitive environment. Over the past few years, there has been increase in hospital merger activity (Gottlieb, 2010). The current trend towards consolidation is a response to competitive environment that has placed greater emphasis on reducing costs and forcing high-cost health care providers out of the market. Health care providers claim that their main motive for merger is to improve efficiency and the quality of care. Consolidation of health care service leads to decline it productivity of doctors because of the decline in economic reward. Research suggests that transition of doctors into becoming employees of health systems and hospitals reduces their general productivity (Gottlieb, 2010). In contrast, consolidation of health care services significantly reduces the cost of health care services to patients, which improves access to quality health care services.

Importance of the topic

This topic has helped me understand the issues that influence the provision of quality health care. Of great significance is the cost associated with ensuring quality health care. The current health system is complex, with many laws, regulations, and standards of practice. All these factors affect the quality of health care service provided by physicians. This topic is important because it informs on the factors that determine the quality of service that patients receive.


Access to quality health care service is essential to all Americans and requires initiatives aimed at ensuring quality health care service to patients. The cost of health care service influence the quality of service that patients receive. This is the main reason why health care providers have embarked on integration of health care services to reduce cost as well as provide quality service.


Gottlieb, S. (2010). No, You Can’t Keep Your Health Plan. The Wall Street Journal.
Centers for Disease Control and Prevention (CDC). (2009). Chronic disease prevention and health promotion. Retrieved 13 December 2009 from http://www. cdc. gov/nccdphp/overview. htm#2. – See more at: http://www. healthtechnica. com/blogsphere/2010/01/25/the-ethics-of-healthcare/#sthash. 8LbN6DOA. dpuf
Rodriguez, R., Ph. D. (2009, December 7). Chat posting. Retrieved from AIU Online Virtual Campus. Chat 1 week 5. The ethical and legal aspects of healthcare: HCM410-0904B-02 website. – See more at: http://www. healthtechnica. com/blogsphere/2010/01/25/the-ethics-of-healthcare/#sthash. 8LbN6DOA. dpuf