Assessing the Benefits and Drawbacks of Unregulated HealthCare Providers

Whether the UCPs use confers beneficial healthcare outcomes or not is subject to the perspective taken. For instance the use of UCPs may help improve access to care where such is limited by the shortage of professionals. On the other hand, employing UCPs to substitute for professional care as a cost cutting measure could have adverse impacts on the clients’ healthcare outcomes. UCPs use may thus bear both positive and negative healthcare outcomes.

Benefits of Use of Unregulated Care Providers

The main advantage of using UCPs is that they improve the access of care for the population. Inadequate supply of professional care givers has reduced the degree to which they can be relied upon to provide services for entire population’s care needs. At the centre of such shortage is the increasing population needing care which has outstripped the available capacity of nursing professionals. Factors such as frequency and severity of global pandemics such as SARS and flu outbreaks (e.g. H1N1), the growing number of individuals getting to old age (>65 years) who need supportive services and reduced hospital stays are contributors to increased care needs in the population (Brennan Centre for Justice, 2007). Further the migration of care givers to countries where their services are better paid for, results in their shortages in countries of origin where these professionals’ services might be in greater need (ICN, 2006).

A second benefit of using UCPs lies in the reduced cost of labour that an organization can gain following their engagement (Brennan Centre for Justice, 2007). Even where the supply of professional care givers is relatively balanced to the population’s needs; “employing lower-cost multi-skilled workers [could] allow institutions to serve the same number of people with fewer higher-paid professional care providers” (Gill, 1996, p. 1). UCPs salaries are considerably lower than those of using professionally trained care givers (Gill, 1996; Brennan Centre for Justice, 2007). With the costs of healthcare increasing globally such cost reductions could help provide affordable care alternatives for the population in need of it. Use of UCPs is however not entirely costless; costs such as institutional training, liability for injuries, increased need for equipment, and the opportunity cost for lost quality of care may reverse the gains achieved by cost savings through lower salaries (Gill, 1996).

When UCPs are trained and appropriately employed a third benefit of allowing professionals to focus on the complex aspects of care could arise (Gill, 1996). For instance different models of home based care for people living with HIV/ Aids have been shown to hold potential for enhanced health outcomes for individuals who cannot afford specialized care in hospitals or care centres (CDC, 2004). Similarly use of alternative care providers such as lady health visitors, and doulas in China, India and Pakistan has traditionally been effective in filling care gaps in regions where access to professionals is absent or over-stripped by the demand (ICN, 2006).  Such observations thus render credence to the continued use of UCPs to meet care needs for the population.

Drawbacks of Use of Unregulated Care Providers

            Irrespective of the benefits highlighted UCPs use may greatly alter the safety and quality of care provided.  A low ratio of professional care givers to other providers has for instance been associated with increased “mortality rate, average length of stay [at the hospital and a higher] rate of re-hospitalization” (Gill, 1996, p. 1). With pandemic outbreaks having increased in recent years, the role of safe staffing in bettering care responses has been highlighted (ICN, 2006). Such a role would be highly challenged when UCPs are being charged with increasingly complex cases requiring higher levels of care (CNO, 2009; CPNA, 2009). Since UCPs have no formal accreditation framework their ability to perform intricate care services may be questionable (CAN, 2008). Similarly the lack of a regulatory framework and clear accountability channel for UCPs could motivate malpractice thus endangering the lives of care recipients (CAN, 2008). When these safety and quality concerns arise, a related inquiry on the adequacy of UCPs training in meeting care services charged to them is needed. There being no uniform system of training, vetting and regulating the employment of these workers the level of care provided in different settings would fail to meet the minimal standards set (CNA, 2008).

Secondly, the cost/benefit arising out of using UCPs as a cost reduction strategy is not clear. To ensure that UCPs can provide the level of care required organizations have to train them and provide an environment that keeps them appraised with the changes in technological and procedural trends in care provision (Gill, 1996; CNA, 2008). Training costs and costs for continued learning of emerging technologies in care provision may ultimately offset the cost savings obtained through labour cost reductions (Gill, 1996). By providing such training, organizations could also be subjected to salary increment demands from UCPs who might feel that their services are inadequately remunerated (CNA, 2008; Brennan Centre for Justice, 2007). In such a way then the entity may be forced to increase these salaries or lose staff hence affecting its service provision. Whether the use of UCPs results to reduced business costs may thus be debatable when these indirect costs are considered.

A third disadvantage of using UCPs has been associated with the required supervision for the quality of their services to be ascertained. Rather than relieving professionals to concentrate on more complex aspects of care, the high levels of supervision required is advanced to actually blur the services offered by these professionals (CNA, 2008). Suggestions that “no task … can always be delegated to a UCP safely because patient care is individualized and patient acuity changes rapidly”, means that the idea that UCPs help nurses to perform their duties more effectively may be a misperception (Gill, 1996, p. 2). Based on studies, regulated nurses working with UCPs have been shown to “spend more time in supervision, but less time in direct patient care” (Gill, 1996, p. 1). Accordingly UCPs use could actually be acting as a barrier for nurses to engage in what they are primarily trained for – providing direct care to patients. Go to the conclusion  here.

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