Theory description and evaluation paper

Theory description and evaluation paper

Introduction

Hospital readmission is defined as the admission of a patient within a specified time after discharge. In most cases, readmissions are in-patient admissions that occur within 30 days after discharge from a healthcare facility. Patient readmissions have been linked to several negative outcomes, including increased mortality rates; several studies have suggested that in-patient mortality rates are higher among re-admitted patients compared to those who are not re-admitted. Readmission is also associated with the increased cost of health care services; readmission leads to longer hospital stays and expenditure of more health resources, which lead to higher costs for the care services. It is estimated that hospital readmissions cost about $26 billion annually. Hospital readmissions can be prevented by appropriate case management during the care process (Banerjee et al., 2021).

Case management is a process that involves facilitating collaboration to assess, plan, implement, monitor, and evaluate the health interventions necessary to meet the health needs of a patient. The case manager assesses the various options available for the patient and recommends the most suitable options to ensure the delivery of quality care services with minimal financial implications. Hospital readmissions are affected by the environmental factors within the health care, and these factors can be controlled or manipulated through the case management process. To explore these factors, Bronfenbrenner’s social-ecological model theory would be appropriate. The theory focuses on external factors that influence the development of children and can be applied to nursing practice to evaluate how hospital readmissions can be prevented using the theory (Hertler et al., 2018). This paper will specifically assess the application of Bronfenbrenner’s social-ecological model theory in case management to reduce hospital readmission rates.

Theory Description

Bronfenbrenner’s ecological systems theory was developed by Urie Bronfenbrenner, who was critical of the theories that then explained child development. He believed that the theories were ecologically invalid, and the laboratory features of previous research that contributed to the development of other theories on child development were not representative of the actual environment that a child grew up in. He looked beyond individual development and included other ecological factors that he believed interacted with the child and affected the child’s development. He then developed the theory based on the environment’s interactions with child development. His theory holds that individuals encounter different environments throughout their lifespan, affecting the way they behave in different situations. Bronfenbrenner proposed that a child’s environment comprises nested structure arrangement where each structure is contained within the next. He then described the structures depending on their impact on a child’s development (Guy-Evans, 2020).

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The microsystem is the first structure, and it includes things that are in direct contact with the child. This comprises relationships with parents, siblings, peers, and other relatives. The microsystem directly influences the child, and the child can also influence the beliefs and attitudes of others in the microsystem. The mesosystem is the second system, and it involves interactions between the different components in the microsystem, but they affect the child’s development. An example is an interaction between a parent and teacher, if their interaction is positive, the child will be positively impacted, and if it is negative, the child will experience the negative impact. The exosystem includes informal and social structures that indirectly affect the child (Hertler et al., 2018). For example, the work environment can impact the parent’s mood and therefore affect the relationship with the child. The macrosystem focuses on the cultural elements, including socioeconomic status, and how they impact the child’s development. Hospital readmissions can be affected by the macrosystem, and the exosystem of a patient, since components such as socioeconomic factors and hospital environment influence the prevalence of disease and general quality of care services (Tan et al., 2020).

Application to Research

Bronfenbrenner’s social-ecological theory has been extensively used in research. Huang et al. (2021) used the theory to assess the influence of social interactions on adult preferences for palliative c