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HCMG101 Health Care Systems Question: Investigate a current phenomenon or issue in the health care delivery system. You will address significance of your research question in introduction/backgrounds and illustrate scientific methods to demonstrate your question. The topic should be relevant to current healthcare delivery system/ health policy or public health programs. A suggested proposal outline corresponds to literatures in peer-reviewed journals. Answer: The Study Design On Increased Medical Costs In The USA There are diverse aspects that are considered in the production and delivery of medicine into the care facility as well as the quality of the care offered to the patient. However, due to the sophisticated technology used and the increased cost of mass medical production, the overall cost of medicine has been huge for the patients 1. For instance, the CDC report of 2015 indicated that most Americans die of heart-related ailments as the patients numbered to 800,000. As a result, the Americans have to pay about $1 Billion per a single day so as to keep the patients alive 2. Another aspect that makes the cost of medicine expensive is the Epinephrine autoinjector commonly called the EpiPen that costs $900 from $90 a decade ago. In order to curb the continuous increase in the costs of these drugs that amass the overall increase in the cost of medicine, it is effective to impose a strategy that will lower the cost. This study design may include the proper public financing and use of cheaper production processes for the drug manufacturing 3.   Introduction There are many issues that arise in the nursing sector including poor care services, knowledge gaps in nursing, unavailability of the registered nurses and the increase in the costs of medicines and care to the patients. In the United States alone, we are facing a number of these challenges in the daily operations. However, this article will strictly discuss the issue of the high cost of the hepatitis C medication both in the public and the private sectors in the healthcare industry due to the increased costs of drugs. These drugs include the likes of Harvoni which costs $87,800, Sovaldi costing $73,800, Epclusa costing $73,300, and Zepatier costing $52,600 among others that are used in the cure of hepatitis C ailment. Despite the fact that there is medical insurance cover including the personal covers, Medicare or the Obamacare, and the newly introduced Trumpcare, the drugs being introduced in the market with a higher price tag that makes it difficult to be catered for by these covers. Methods The continuous increase in the costs of drugs here in the United States not only affects the patients’ ability to afford the medication but also the ability of the state to kick the hepatitis C ailment out of the nation 4. Thus, implementing an appropriate study design can effectively aid in this reduction. For instance, the production process of these drugs can be subsidized by the government through the contribution by the taxpayers’ money in the purchase of the raw materials used 5. In addition, the funding can be used in further research so as to determine the cheaper means and alternatives of these drugs production that may result in cheaper healthcare to the masses. Once the subsidizing has been done, the production of massive drugs that are cheaper in price is attained since most costs that could have been paid by the customer while purchasing the medicine has already been catered for in the production costs 6. Better research on the production process may even reduce the costs of production of these drugs as machines, such as robots, can be used instead of the expensive human labor. The efficiency that will be attained by the used of these robots will be increased when compared to that of the human power as they are programmed to work in a fixed schedule minimizing chances of errors. The study setting can be best set on the natural participant’s setting in the hospitals and drug production factories since the design is quantitatively based. Since the cause of the expensive medication is increased drug production costs, the setting can never be on the consumers or the clinics and care homes 7. Thus, these recommended strategies can be best applied in the areas where the medicines are being produced which include the drug processing firms and other medical research firms and laboratories. The population considered in this study is the patients and their caregivers since they are the ones affected by the changes in the costs of the hepatitis C drugs. These persons are eligible for the research as they are the daily users of drugs and any slight change in the costs of the drugs and other medical factors affect them. However, these drugs are effective as they can be taken on a daily dose with or without the combination of other medicines and have high efficiency in the hepatitis C treatment. The variable of the implementation of this study design includes a better change in the costs of the drug production costs that, in return, reduce the overall cost of healthcare. However, the type of ailment that a patient is being diagnosed with varies as some are more costly than the others. The statistical methods used in this study design include the basic and specific methods. For instance, the exploratory and descriptive methods, which are the basic methods of statistics, can be used in the extraction of data from the affected individuals that include the nurses and the patients who are affected by the direct increase in the cost of the medicines. However, in order to allocate the exact cause of the increase in the cost of drugs, a more detailed statistical method, precisely the quantitative analysis 8, has to be done on the figures presented by the medical procurement process. From this analysis, the change of the cost of medicine that has been as a result of an increase in the drug production process has been identified. For instance, the EpiPen used to cost $90 some years ago back in the 1980’s but it currently costs $900. References Center of Disease Control and Prevention. Heart Disease And Stroke Cost America Nearly $1 Billion A Day In Medical Costs, Lost Productivity. April 29, 2015. Available at: Accessed 2018.      Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes: Oxford university press; 2015.      Obama B. United States health care reform: progress to date and next steps. Jama. 2016;316(5):525-532.      Squires D, Anderson C. US health care from a global perspective: spending, use of services, prices, and health in 13 countries. The Commonwealth Fund. 2015;15:1-16.   Dieleman JL, Baral R, Birger M, et al. US spending on personal health care and public health, 1996-2013. Jama. 2016;316(24):2627-2646.      Stoddart GL, & Evans RG. Producing health, consuming health care. In Why are some people healthy and others not?: Routledge; 2017.   Kulldorff M. Statistical methods for spatial epidemiology: tests for randomness. In GIS and Health, CRC Press. 2014:67-80.

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