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Article Analysis – Health Care Burden Associated With Outpatient Opioid Use Following Inpatient Or Outpatient Surgery
Article Analysis – Health Care Burden Associated With Outpatient Opioid Use Following Inpatient Or Outpatient Surgery
Student Name
Hodges University
Course Number and Title
Professor Name
Date
Brummett, C. M., England, C., Evans-Shields, J., Kong, A. M., Lew, C. R., Henriques, C., … & Oderda, G. (2019). Health care burden associated with outpatient opioid use following inpatient or outpatient surgery. Journal of Managed Care & Specialty Pharmacy, 25(9), 973-983.
Summary
The use of prescribed opioids to treat postsurgical pain has been linked to long-term opioid dependence and increased healthcare consumption and expenses. The study’s primary objective was to compare the cost of health care for opioid-naive adult patients prescribed opioids following major surgery to opioid-naive adult patients not prescribed opioids. Data from IBM Watson Health MarketScan Research Database was utilized in the study. The eligibility criteria for the participants included opioid-naïve adult patients who had undergone major surgery, whether inpatient or outpatient, with at least one year of continuous admission, prior to and after the index surgery. During the post-index period, acute medical outcomes, opioid use, healthcare utilization, and costs were assessed; however, index surgery hospitalization and day of index outpatient surgery were excluded. The study results indicate that opioid users were younger, more likely to be female, and had a larger preoperative comorbidity load than nonopioid users across all three payers (commercial, Medicare, Medicaid). Opioid users had increased hospitalizations, emergency department visits, and pharmacy claims. In conclusion, a year following inpatient or outpatient surgery, filling an outpatient opioid prescription was linked to higher health care utilization and costs across all payers.
Relevancy
The research is relevant to the study of our health systems in various ways. First, it involves utilizing health care services among inpatient and outpatient individuals who have undergone surgery. Second, it seeks to assess acute medical outcomes, opioid use, healthcare utilization, and costs. Chapter 5 of the textbook looks at inpatient and outpatient services. The difference between inpatient and outpatient care is that inpatient services are provided while a patient is admitted to the hospital and has to stay overnight while an outpatient receives care without admission to the hospital. Inpatients and outpatients have different health needs, and thus, the cost of accessing health care may differ even if the patients have a similar condition. Those admitted to the hospital will receive higher billing than outpatients.
Opioid addiction is a major issue in the community, and many patients who have received surgery have fallen into opioid addiction. According to the article, opioid use was common to both inpatient and outpatient after discharge but was less common among Medicare patients as compared to commercial and Medicaid insurance. The finding of study concluded that filing an outpatient opioid prescription was associated with cost and increased healthcare utilization. This implies that individuals who frequently sought health care services had a higher chance of applying for opioid medications. In the same case, if the cost of the opioid medication was cheap, more patients would seek to fill prescriptions.
Reaction
The article is right regarding the utilization of opioid medication in health care. Many people go to a hospital without a drug addiction problem, but after prescription, they end up becoming addicted, and this increases their opioid use. According to the article, most of the individuals who participated in the study had never had an opioid problem, but soon after their first surgery, regardless of whether they were admitted or not, as long as they were prescribed some opioid medication, they ended up depending on them a year after discharge. This is a major problem in the hospitals as it cannot be considered as a healthcare utilization, but a drug den, where the people filling the opioid prescriptions are already healed but depend on the medication for their daily routines. It is advisable that pharmacists or health institutions find an alternative to pain-relieving medication which is not addictive to avoid making patients slaves to opioids.
Home Schooling, kind of education which children receive at home
Home Schooling, kind of education which children receive at homeAbstract
Home based education or what is commonly referred to as home schooling is a term used to describe the kind of education which children receive at home, especially by parents and at other times by tutors. These children do not have to go to formal settings of private or public schools. This kind of education has become an alternative in most western countries although it was the main kind of education practiced before the introduction of the present compulsory laws on school attendance. The paper, hence, is going to look at some of the main issues commonly associated with home schooling. The paper will use a number of resources to argue this issue comprehensively, some of them including books, chapters, and even database sources.
Introduction
Home based education is an option for parents, which is legal in most developed countries, to provide their children with education at a different environment than that offered by private and public schools. There are numerous reasons parents cite for wanting to provide their children with education at these alternate locations. Parents have, for example, indicated that they prefer to educate their children at home because there is no religious education a home as compared to public schools. Some parents fell that it is inappropriate to ‘shove’ religion at the throats of children. Rather it should be the choice of these children to associate or affiliate themselves with a religion of their choice. As a result, they feel that when they tutor and teach their children at home they are in less danger of being forced to affiliate themselves with a religion (Pfleger, 1998).
Parents who practice home schooling have cited the presence of gangs in public schools as a reason why they choose to tutor and educate their children at home rather than in these schools. Parents are afraid that if they take their children in such schools, their children might come to harm or become a part of those gangs. Gangs in schools and particularly, public schools have become a big concern for many parents. Other parents feel that most public schools have huge classes where they doubt whether their children get any attention. They feel that their children have a better chance of learning at home than in these schools where teachers and tutors hardly get any chance to interact in person with each student. As it follows, they opt to teach and educate their children at home because it is at home where their children get individual attention and, thus, a better chance of doing well in education (Pfleger, 1998).
All in all, it is clear from the above cited reasons that real issues are concerning parents at public and private schools to make them want to educate their children at home. This should say something to school teachers and tutors. Teachers must ask themselves what is it that they are doing wrong for a significant number of parents to opt to educate their children away from schools. Home schooling should, hence, be a real concern for teachers about the teaching methods used at school and the kind of environments they have created at schools, even though some parents just choose homeschooling for other reasons such as personal choice, parenting style, and an option for parents living abroad (Pfleger, 1998).
Home based education is legal in all 50 states, and each day, more parents are opting out of public school education to educate their children at home. As already seen, this is due to numerous reasons. There are also numerous issues cropping out from the debate of the success homeschooling. One of these issues surrounds the matter of home school teacher qualification. Today, when individuals talk about home based education, one question usually comes up. This is whether the parent or the home tutor has the required qualifications to tutor a child. Qualifications of these parents and home tutors has become a significant concern because opponents of this system of education believe and argue that parents do not possess the right qualifications to teach and educate children like a trained and certified teacher. Though it is true that teachers have higher teaching and tutoring accreditations when compared to parents, it is also true that parents have the ability to tutor and educate children in any class and especially those children in elementary classes (Moore & Moore, 1993).
When one is arguing this matter, they should realize that homeschooling gives certain benefits to the child when compared to public and private schools. For example, if a child has a question at home, they can ask it as many times as they want unlike in schools where the time might be inappropriate to ask or where the teacher might be too engaged to address the question. It is not possible for one to know answers, even when they are qualified teachers. It has been argued that parents have better abilities to shape the minds and futures of their children unlike teachers who only tutor the children for a year, and who care less for the children (Moore & Moore, 1993). However, it should be noted that parents need to sharpen their skills if they decide to tutor their children at home. For example, they can use online sources, co-ops, correspondent courses, as well as, community college classes so as to add on to the resources they have on homeschooling. With these additional classes, parents can become highly competent in teaching their children in different subjects, and they can also provide their children with the same benefits as they would get with a teacher in school (Law. Co-op, 1978).
Also parents should realize that end of term or year testing is essential. Testing has been made a requirement in all state schooling guidelines, and it should be utilized in home based education to prove that this kind of education is effective as school based education. Public and private schools undertake these tests and it would also be sensible to include them in home schooling. Like a number of states assert, all home schools must be registered and their end of year scores submitted so that the progress of these children can be ascertained. Studies show that regulations of testing by the state on the degree of qualification of the parent, which can range from certified teacher to no high school diploma to non- relational degrees, and laws on compulsory attendance, have not essential significance when it comes to the achieved scores on tests (Moore & Moore, 1993).
The subject of home schooling has also led to another issue of content knowledge and parents. For one to educate children appropriately, and according to the current standards, teachers, tutors and parents have to understand the subject matter flexibly and deeply so that they can help the learners create essential cognitive maps, address and solve misconceptions, and associate different ideas to each other. As it follows, tutors, teachers, as well as, parents who have undertaken home schooling have to understand and comprehend how ideas link across different fields and to each day’s life. This type of understanding helps them by proving them with a basis for pedagogical content knowledge that makes it possible for them to create ideas accessible to others (Shulman, 1987b).
It has been argued that parents who practice home schooling do not have the appropriate and the needed content knowledge to make the learning of their children successful. The concept of pedagogical content knowledge was introduced by Shulman in 1986. This concept argues teachers knowledge and understanding of their subject matter is essential for successful and effective teaching. In his theoretical framework, Shulman argues that there is a need for teachers to master two kinds of knowledge; one is the kind of knowledge usually referred to as deep knowledge of the subject the teachers and tutors have to teach, and second, the curricular development knowledge that these individuals must possess so as to effectively come up with a curricular effective in learning (Shulman, 1987b). Content knowledge includes what is referred to as structure of knowledge, which also encompasses a number of principles, theories, and concepts useful in a certain discipline. What us especially essential is the content knowledge that fosters in teachers the better methods of teaching processes, including the most effective forms of communicating and representing content and how best students learn certain topics and concepts of a subject. As it follows, it has been indicated that parents who have not received any training, as well as, beginning teachers do not have the required content knowledge to make education successful. They, therefore, have to struggle with, and must learn different pedagogical knowledge or content, in addition to, general pedagogy or generic principles of teaching (Shulman, 1987b).
Pedagogical content knowledge has also become another serious issue in home based education. Pedagogical content knowledge can be understood as integration or the combination of three different, essential aspects of learning; content or what is commonly referred to as subject matter, instructional methods, or pedagogy, and characteristics of a learner (Shulman, 1986a). What has fueled the issue is that opponents of home schooling believe that training teachers and tutors is essential in developing and sharpening skills in all the above aspects. They, therefore, do not see how home school tutors and parents, who are not trained can effectively educate children when they have not been trained on how to attain efficiency in these matters. They argue that pedagogical content knowledge relates directly with the quality of education and success of candidate in tests.
As a result, if a parent, a tutor, or even a teacher does not possess any of these qualities or education aspects, they cannot effectively teach their children. To counter these arguments, supporters of the home based education have indicated that experienced tutors and parents have better pedagogical content knowledge especially because they have better knowledge of the characteristics of their students, and they have better designed instructional methods that they have devised and designed according to the characteristics of their students, who they know better. All in all, it should be realized that pedagogical content knowledge is an essential aspect in effective and successful education that both parents and teachers can attain with the proper training and with time, through experience. Parents, though adequately equipped, must also consider attending some training or courses that can help them become better equipped tutors for their children (Shulman, 1986a).
One of the most important concerns of all concerns among the opponents of home based education is socialization and acquisition of socialization skills. Socialization can be defined in numerous different ways but one of the most obvious definitions is that socialization is the ability of an individual to adapt or to convert to the needs and wants of the society. Another essential definition in this case is the ability for individuals to make themselves fit for association with others, and make themselves sociable. It is a wide believe of many individuals that children need to socialize with others in order for them to become meaningful and productive society members. It has become the concern of many, therefore, that children who are homeschooled will not acquire the right and the appropriate socialization skills for use in the future since they spend most of their time in their houses and with their parents (Taylor, 1998).
However, it should be noted that socialization and fitting in are two extremely different concepts that people should not confuse. One, for example, cannot say that a child is not social enough when they do not fit in with other children who do not have the same moral values. Parents practicing home schooling argue that it is hard for children when they are impressionable and young to differentiate which children are bad influences and which children are not until it is too late and they have already been steered in the wrong direction. They argue that it is at this age where peer pressure becomes an issue, when children want to copy what their friends are doing and how they are acting in order for them to feel accepted and for them to fit in. for these parents, this is not socializing, and it is for this reason why these parents want to home school their children and protect them from bad influence (Taylor, 1998).
After the completion of primary education, most students opt to stop home based schooling in the favor of public higher institutions of learning at established universities and colleges. Though reservations still remain about the qualifications of these students and the quality of education they have received in the previous years, studies have indicated that most public and private universities and colleges are increasing the number of admissions of students who have been home schooled. To ensure that their children pass as candidates for these colleges and universities, parents must ensure that their students undertake standardized test scores that can be useful in helping these students enroll in college. One thing that is extremely essential is that students who have a home based education, must always keep their detailed portfolios and records, as they can be highly crucial in determining whether they get enrolled in college or not. Just like colleges, employers and most corporate are also increasingly becoming open to students who have attained home- based education. Though, the scene is changing to include more and more of students from home schools, these students must strive to have and keep their records as proof of education (Greene & Greene, 2007).
Conclusion
Home based education has become an increasingly common phenomenon in the current world. With this sort of education, however, several issues have arisen indicating that caution must be taken whenever a parent chooses to home school their children because a number of challenges can affect the quality of education a home- schooled child has. Such challenges might have more or less to do with socialization, quality of education, and admission to higher education institutes and employment.
References
Greene, H. & Greene, M. (2007). There’s no place like home: as the home school population grows, college and universities must increase enrollment efforts targeted to this group (Admissions). University Business, 25(2).
Law. Co-op. (1978). .Alternative Statutes Allowing for Home Schools: Mass. Ann. Laws ch. 76, I.
Moore, R. S. & Moore, D.N. (1993). Better late than early. New York: Seventh Printing.
Pfleger, K. (1998). School’s out. The New Republic. Washington 218 (14), 11-12.
Shulman, L. (1986a). Those who understand: Knowledge growth in teaching. Educational Researcher, 15 (2), 4-14.
Shulman, L. (1987b). Knowledge and teaching: Foundations of the new reform. Harvard Educational Review, 57 (1), 1-22.
Taylor, V. (1998). Self-Concept in home-schooling children. Berrien Springs, MI: Andrews University.
Article 1a Assignment – PSYC 4033
Article 1a Assignment – PSYC 4033
Dr. McDonald – Spring 2022
Article 1a—date due: Feb 8
Your name:________________________________________________
AUTHORS OF ARTICLE:____________________________________
Instructions: Please use this and only this sheet to answer the questions regarding your assigned article; in other words, be succinct. Incomplete sentences are acceptable as long as they get the message across. Use the space allotted and no more! USE YOUR OWN WORDS – NO PLAGIARISM AND NO QUOTING!!! Most importantly, put answers in everyday language.
Motivation for the study: ________________________________________________________
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Hypotheses/Predictions: ________________________________________________________
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Independent Variable(s) EXP’T 1 only – only list ones used; there may or may not be extra lines In addition, clearly circle between or within subjects for each IV
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Control Variable(s) EXP’T 1 only —list two
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Dependent Variable(s) EXP’T 1 only—only list ones used; there may or may not be extra lines
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Results – a) interpret Figure 3 on page 1094. What does it show? Does it match the predictions? b) interpret Fig 4 on page 1095. What does it show? Does it match the predictions?
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Relation to class material – use pages 119-126 in the Baddeley et al. textbook to find a study that relates directly to this one. Give the name of the authors of that study and a brief description of their findings. Describe similarities and differences between that study and the one you just read in terms of materials, experimental design and results. How do these two studies relate to a general topic from the class?
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