Optimal Care for Maternal and Infant Health
Mrs. Brown, a 26-year-old waitress, had regular contact with her gynecologist for contraception and general health monitoring until deciding to become pregnant. A year later, she sought fertility treatment and had monitoring through normal pregnancy and delivery. Her newborn’s checkups and immunizations follow national guidelines.
Population (in United States)
10 million (4 million mothers and babies, 2 million fertility problems)
$12,000 per delivery, $2,000 per infant, $1,000 per fertility problem
Priority Concerns for This Population
Healthy babies, low maternal risk, control of fertility
Major Components of Health Care
Prenatal services, delivery, and perinatal care; fertility control and enhancement
Goals for Health Care
Optimal Care for Maternal and Infant
Basic cost for health care services, treatments and support services are covered fully. In addition where appropriate lifestyle related interventions, screening and prevention activity are also covered.
The coverage is universal and not dependent on the condition, stage of life or ability to pay. Current arrangements through Medicare, the VA or other insurers will continue to provide services. Easy to use tools to most effectively choose health coverage plan. Prevention and early diagnosis is fully covered under his health plan. Additionally lifestyle improvements are also covered. Plans may compete of riders for additional services. Employers may also provide additional services
The healthy person selects his provider for prevention utilizing a Primary Care physician, local pharmacy, or certified health club. The person has a primary care doctor who will coordinate their care and provide resources for health lifestyle, screening and preventive activity. There are community resources available for various healthy activities. Public web sites and other media services as well as social organizations promote Optimal Care. Certified health clubs provide more specialized services. Equal access to health care services; equal access to healthy lifestyle choices, health education, and maintenance; opportunities tailored to situation. Administrative needs are minimal.
Quality Health Care:
Patient Centered (No Helplessness or Unjustified Routines): Care is patient centric and is provided with dignity, cultural sensitivity and respect for the person. Information is provided in age and education level appropriate manner. Informed and shared decisions reflecting parents’ values (constrained by legal limits).
Safe (No Harm): Care that is provided will be safe from errors. This will be of particular importance regarding immunizations and programs for physical activity. Minimal and known risk from false positive or false negative screenings. Minimal and known risk from false positive or false negative screenings; no perinatal or maternal injury or death from health care; minimal infertility; no undesired pregnancy
Effective (No Needless Failures): Specific outcomes will be measures and adjustment in the services made. Recommendations from national agencies and groups will be followed. Evidence-based prenatal care, delivery, and postnatal care; evidence-based primary and secondary preventive interventions for both mother and child.
Efficient (No Waste): For brief acute episodes, diagnosis is made and care provided in timely efficient manner. For immunizations particularly for children, a plan is formulated according to an informed dialogue with the person or their legal representatives. Government and professional association guidelines are readily available and are transparent. Regulatory agencies oversee quality of services, and advertisement to consumers. Backup experts available; planned rapid transfer of seriously ill newborns; evidence-based fertility services.
Timely (No Needless Delays): Evaluation and treatment for brief acute episode is available promptly. Convenient and responsive scheduling, no waiting for health care services; immediate access to results of tests; immediate access to clinical guidance and other information; timely education and support; rapid transfers when needed.
Equitable (No Unjustified Variation): Preventive services are provided universally with no bias due to personal characteristics. Regulatory agencies oversee quality of services, and advertising to consumers. Informed and shared decisions reflecting parents’ values (constrained by legal limits).
Coordination of Care:
Care is patient centric and revolves around the patient and their doctor. Public health services that have provisions for early identification of community trends. Education regarding risk factors and practical ways to avoid them. For identified problem and secondary prevention, care is coordinated regionally, through medical records, supported by privacy provisions.
The goal of innovation is to improve quality of the person thorough achieving and maintaining optimal function. Personalized medicine, identified early susceptibility based on genetics, technological tools to assure compliance with treatments and ability to monitor response to interventions. Utilization of personal medical records that can automatically provide reminders of needed screening, immunizations and monitoring response. A personal record of treatments for acute episodes including medications and side effects that is paper or electronic based. Advance care plans available for those interested. Access to information about treatment options is available in language and level of education of the person. Secure message capability.