DISCUSSION 1

CONTINUUM OF CARE SCENARIO: PEER-REVIEW DISCUSSION 1 OF 6For this Discussion, you will have the opportunity to review the work of others and provide them with peer-reviewed feedback, as well as consider how their continuum of care might be improved. Further, you will be able to compare and contrast the other countries identified by your colleagues, outside of the United States, that are recognized for organizing care around medical conditions.

In this Discussion, you will continue to analyze your continuum of care scenario using the value-based care model, the IOM Aims, and a country comparison. You will share your suggestions for improvements. Then, you will provide peer-review feedback on your colleagues’ suggestions, and they will do the same for you. This feedback will be incorporated into Week 4 Assignment, which you should continue to update through Week 4.

RESOURCES

Be sure to review the Learning Resources before completing this activity.

Communicate and plan with your colleagues to ensure that everyone receives peer-review feedback from two or more colleagues. It is recommended to designate who will provide feedback to whom. Additionally, consider varying the individuals who provide feedback in the peer-review Discussions so that everyone can receive more diverse perspectives in the feedback they receive.

Locate your Community Profile and Continuum of Care document that you developed in Week 2 and return to your continuum of care scenario. Research how your community and specific diagnosis relate the following:

The value-based care element of:

Organize care around medical conditions

.

The IOM Aim of: Be patient centered.

Additionally, research and identify a country outside of the United States that has a healthcare delivery model that closely aligns with the value-based care element of “organize care around medical conditions.”

BY DAY 3

Post your evaluation of a continuum of care scenario and country comparison based on your Week 2 Community Profile and Continuum of Care scenario, to address the following:

In one sentence, briefly identify the city/state in which your health community is located, the specific diagnosis for your identified health issue, and the country you used as a comparison.

Using at least one scholarly source, propose at least one improvement that could be made based on the following element of the value-based care model:

Organize care around medical conditions

Using at least one scholarly source, propose at least one improvement that could be made based on the following IOM Aim:

Be patient-centered

Using at least one scholarly source, compare your community’s model of healthcare delivery to the delivery model of the country that closely aligns with the value-based care element of “organize care around medical conditions.” What lessons—positive or negative—could your community learn from the other country?

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Community Profile and Continuum of Care
Annet Castillo
Walden University
Contemporary Topics in the US Healthcare Delivery System
07/12/2024
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Introduction
Adolescence is faced with the emergence of cognitive and sexual maturation that requires
significant balance to ensure the understanding of issues such as sexual and reproductive health
(SRH). Maintaining this balance is, however, complex and challenging, resulting in the rise of
unintended pregnancies among adolescents (Chakole et al., 2022). These teenage pregnancies,
however, are also expressive of underlying factors in the community. In exploring this public
health issue of teenage pregnancies, this paper will help Kansas City, Missouri, to contribute to a
multifaceted approach to improving outcomes for adolescents in their SRH.
Community Profile
Kansas City, Missouri, is well known for its culture and heritage. However, the city faces
a concern of high teenage pregnancy rates. In a CDC (2022) data report, Kansas recorded a 16.2
birth rate per 1000 births of girls between the ages of 15 and 19. These birth rates are three times
higher than other selective states in the country. However, as a vibrant center, the city is
influenced by several factors that contribute to the growing number of teenage pregnancies.
Description of the Community
Kansas City has the highest population and size among all cities in Missouri. Data USA
(2022) report shows that this town covers around 320 square miles, and its location holds more
than 509,000 people. Its vibrancy is one of the reasons why it stands out as a richly cultural city
across the country. Kansas County has an estimated population of over five hundred thousand
residents with an average age of thirty-five years, the majority being American citizens.
However, there is a vast range of cultures in the city; African Americans account for 26% of its
total population, while white people constitute slightly above fifty-five percent, and Hispanics
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are above twelve percent. A large percentage of the Kansas population is educated, with women
representing a higher population than men.
Social Determinants of Health
According to Chelak & Chakole (2023), the social determinants of health play a
significant role in accounting for the general health and well-being of the population. For
instance, one of these factors includes income and economic stability. In Kansas, in February
2023, 2.1% of the population was employed with a median household income of $65,000.
However, the city also experiences a poverty rate of over 14%, with a majority of the population
comprising marginalized groups such as blacks and Hispanics (Data USA, 2022). This limits
opportunities for these individuals, further contributing to the limited access to health and crime.
In addition, Kansas is well educated, with a majority of the white population (over 64%)
graduating at the university level, followed by 11 percent of the Black population, Hispanic, and
Asian community. According to the Kansas Association of School Boards (2022), quality of
education in public schools ranked 39th in the country. Despite the ranking providing quality
education, schools in the rural areas of Kansas, especially among minority populations such as
Hispanic and the Black community, fail to receive this standard and acquire knowledge of SRH,
leading to increased pregnancies in these areas. In addition, according to Willeke (2021), Kansas
City had a violent crime rate with a 9% increase from the previous year. These high crime rates
limit the general population’s safety, which contributes to severe physical and mental health
issues. Lastly, there is access to health services. In 2022, 88% of Kansas had health coverage in
Medicaid, Medicare, or VA plans. This coverage comprises both children and adults. However,
11 percent of the population lacks insurance coverage, contributing to poor health outcomes.
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Leading Causes of Death
According to a Kansas report in 2021, the leading cause of death in Kansas was heart
disease. The reports showed a 176-death rate per 100,000 individuals dying from heart disease, a
number that is higher than the US population rate. The second cause of death in the city is
cancer, with the disease predominantly affecting the older population. However, these leading
causes of death also vary according to the ages of the population. For instance, although heart
disease and cancer are the leading cause in the city, it mainly affects the older generation, with
the age group ranging from 45 to 85 years old. This rate is different compared to the younger
population. Among the younger population, however, the leading causes of death included
unintentional injuries, suicide, and homicides. This affected mainly 15 to 34-year-olds in the
region, which significantly accounted for over 68 percent of the deaths in 2022 (Data USA,
2022).
Health Care Settings in the Community
Teenage pregnancies increase the risk factors for health complications and unintended
injuries (Ray et al., 2024). Addressing these accidents can be complex, requiring a
comprehensive and multifaceted approach that accounts for the different aspects of the
community. This comprehensive approach should be applied in the continuum of care, which
involves essential elements such as education and care.
HealthCare Setting (1)
For a hypothetical 13-year-old teenage pregnant patient seeking counseling and guidance
on her pregnancy care while reducing the complications and accidents related to early
pregnancies, such as falls, the first healthcare setting encounter in Kansas, for this patient, they
might encounter would be the EMS. The EMS plays a significant role in the community. They
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provide different services relating to the conditions of the patient. For instance, for ages 10 to 21,
the EMS can offer guidance and education to young female adolescents on the SRH, thus
reducing the risk of teenage pregnancies. However, the patient might first encounter the EMS,
who would assess the risk factors associated with adolescent pregnancy. In addition, they would
also offer education services on nutrition, injury prevention, mental health services, and guidance
to prevent other causes of death, such as suicide. With a specific focus and training in handling
teenage pregnancy, the EMS effectively addresses the patient needs comprehensively.
HealthCare Setting (2)
Another hospital setting they would encounter is the Hospital ER. The Hospital ER is
particularly tailored to protect patients from death or address trauma-related issues (Mutlu et al.,
2021). Due to their urgent services, the ER is often open to address the emergency the public
requires. These services are broad and cater to all individuals of the public. In some institutions,
these departments can be specialized for patients needing urgent care, such as teenagers who
require urgent treatment. This is because teenage pregnancies can be critical, such that they lead
to complications that require urgent treatment for the patient. This ER is also equipped with
professionals who can help the teenager navigate the pregnancy complexities and the options
needed for positive outcomes.
HealthCare Setting (3)
In addition, the patient might also undergo hospital surgery. According to WHO (n.d.),
almost 55% of teenage pregnancies result in abortions. This action and choice can be detrimental
and result in complications during the process, which can contribute to mortality rates. Due to
their young age, the patient might consider other options such as abortions, which would lead her
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to the surgery, or during delivery, she might opt to deliver the surgical way. The hospital surgery
offers comprehensive care to the patients. It provides a holistic team specialized in adolescent
medicine, ensuring a comprehensive treatment plan. These services ensure easy navigation
through the childbirth or the abortion process.
HealthCare Setting (4)
Another setting they might encounter is the hospital rehab center. The hospital rehab
center is a rehabilitation space that ensures recovery. This center provides a comprehensive team
that addresses the incident around unintentional injuries. For instance, they offer educational
services, counseling, and guidance to help the patient deal with the trauma and move on from the
event, thus ensuring a positive outcome.
Conclusion
Addressing teenage pregnancies is a complex and challenging task, mainly when it is
influenced by significant and different factors in the community (Vieira Martins et al., 2023).
The paper, therefore, provides a detailed analysis of the high teenage pregnancies in Kansas,
Missouri. Kansas is a large city with a bustling and diverse population. However, the community
also experiences socioeconomic challenges such as high poverty rates and inadequate quality
education, especially in rural areas, that contribute to teenagers lacking efficient education on
their SRH, contributing to high teenage pregnancies.
The continuum of care should be comprehensive and holistic. This care should be
holistic, regardless of the health service setting. Teenage pregnancies can be severely
consequential, leading to unintended injuries such as falls or miscarriages that could lead to
increased mortality rates. In the analysis of the continuum of care of unintentional accidents
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among teenage pregnancies, the paper analyzes and describes different hospital settings a patient
with adolescent pregnancy might encounter in the community.
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References
Chakole, S., Akre, S., Sharma, K., Wasnik, P., & Wanjari, M. B. (2022). Unwanted teenage
pregnancy and its complications: a narrative review. Cureus, 14(12).
Chelak, K., & Chakole, S. (2023). The Role of Social Determinants of Health in Promoting
Health Equality: A Narrative Review. Cureus, 15(1), e33425.
https://doi.org/10.7759/cureus.33425
CDC. (2022). Teen Birth Rate by State. National Center for Health Statistics.
https://www.cdc.gov/nchs/pressroom/states/kansas/ks.htm#lcod
Data USA. (2022). KANSAS CITY, MO. https://datausa.io/profile/geo/kansas-citymo#education
Mutlu, S., Çetinkaya, A., & Yılmaz, E. (2021). Emergency Service Perceptions and Experiences
of Patients: “Not A Great Place, But Not Disturbing.” Journal of Patient Experience, 8,
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Kansas Association of School Boards. (2022). Kansas Ranks High in Most New Measures of
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Ray, J. G., Fu, L., Austin, P. C., Park, A. L., Brown, H. K., Grandi, S. M., … & Cohen, E. (2024).
Teen pregnancy and risk of premature mortality. JAMA network open, 7(3), e241833e241833.
Vieira Martins, M., Karara, N., Dembiński, L., Jacot-Guillarmod, M., Mazur, A., Hadjipanayis,
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of paediatrics. Frontiers in pediatrics, 11, 1119500.
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Willeke, B (2021). FBI data: Kansas City ranks in top 10 of highest violent crime rates in U.S.
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ior%20year.&text=Springfield%20saw%202%2C545%20violent%20crimes,10.
WHO. (n.d.). Adolescent pregnancy. https://www.who.int/news-room/factsheets/detail/adolescent-pregnancy