The incidence of chronic disease has increased as mortality rates have decreased.[1] It is estimated that by 2030 half of the population of the USA will have one or more chronic conditions.[2]
According to the CDC, 6 out of 10 adults in the U.S. are managing at least one chronic disease and 42% of adults have two or more chronic conditions.[3]
Conditions, injuries and diseases which were previously fatal can now be treated with chronic care. Chronic care aims to maintain wellness by keeping symptoms in remission while balancing treatment regimes and quality of life.[1] Many of the core functions of primary health care are central to chronic care.[4] Chronic care is complex in nature because it may extend over a pro-longed period of time, requires input from a diverse set of health professionals, various medications and possibly monitoring equipment.[5]
According to 2008 figures from the Centers for Disease Control and Prevention chronic medical care accounts for more than 75% of health care spending in the US.[1] In response to the increased government expenditure in dealing with chronic care policy makers are searching for effective interventions and strategies. These strategies can broadly be described within four categories. These are disease prevention and early detection, new providers, settings and qualifications, disease management programs and integrated care models.[6]
Challengesedit
One of the major problems from a health care system which is poorly coordinated for people with chronic conditions is the incidence of patients receiving conflicting advice from different providers.[2] Patients will often be given prescriptions for medication that adversely interact with one another. One recent study estimated that more than 20% of older patients in the USA took at least one medication which could negatively impact another condition.[7] This is referred to as therapeutic competition.
Effective chronic care requires an information platform to track patients' status and ensure appropriate treatments are given.[8]
There is a recognised gap between treatment guidelines and current practice for chronic care.[9] Individualised treatment plans are critical in treating chronic conditions because patients will place varying important on health outcomes. For example, some patients will fore-go complex, inconvenient medication regimes at the expense of quality of life.[9]
Multiple conditionsedit
One of the greatest challenges in this field of health care is dealing with the co-existence of multiple long-term conditions, also known as multimorbidity.[5] There are few incentives within current health care systems to coordinate care across multiple providers and varying services.[2] A 2001 survey by Mathematica Policy Research found that physicians feel they have inadequate training to deal with multiple chronic conditions. An increase in the number of chronic conditions correlates with an increase in the number of inappropriate hospitalizations.[2] Self-management can be challenging because recommended activities for one condition may be made difficult because of another condition.[9]
Chronic care is a patient-based approach to provide chronically ill patients with the knowledge and resources to help them better understand their conditions and to help them to adhere with treatment for better outcomes. Chronic care patients may require the services of a variety of care providers, including dietitians, nutritionists, occupational therapists, nurses, behavioral care, pain management, surgery, and pastoral care. Working in collaboration with the patient, the chronic care provider coordinates care these and other specialist providers. Additionally, the patient may require palliative or hospice care, especially at end of life.
^ abcLarsen, Pamala D. (2011). "Chronicity". In Lubkin, Ilene Morof; Larsen, Pamala D. (eds.). Chronic Illness: Impact and Intervention. Jones & Bartlett Publishers. pp. 3–4. ISBN978-0763799663. Retrieved 10 March 2014.
^ abcdGerard Anderson (2010). "Chronic Care: Making the Case for Ongoing Care". Robert Wood Johnson Foundation. Retrieved 14 March 2014.
^"Chronic Diseases in America". CDC. CDC. Retrieved 16 November 2020.
^Kane, Robert L.; Reinhard Priester; Annette M. Totten (2005). Meeting the Challenge of Chronic Illness. JHU Press. p. 93. ISBN0801882095. Retrieved 15 March 2014.
^ abEllen, Nolte; Cécile Knai; Martin McKee (2008). Managing Chronic Conditions: Experience in Eight Countries. WHO Regional Office Europe. p. 2. ISBN978-9289042949. Retrieved 11 March 2014.
^Busse, Reinhard; Miriam Blümel; David Scheller-Kreinsen; Annette Zentner (2010). Tackling Chronic Disease in Europe: Strategies, Interventions and Challenges. WHO Regional Office Europe. p. 3. ISBN978-9289041928. Retrieved 11 March 2014.
^Lorgunpai, Songprod Jonathan; Grammas, Marianthe; Lee, David S. H.; McAvay, Gail; Charpentier, Peter; Tinetti, Mary E. (February 25, 2014). "Potential Therapeutic Competition in Community-Living Older Adults in the U.S.: Use of Medications That May Adversely Affect a Coexisting Condition". PLOS ONE. Public Library of Science. 9 (2): e89447. Bibcode:2014PLoSO...989447L. doi:10.1371/journal.pone.0089447. PMC3934884. PMID 24586786.
^Brodsky, Jenny; Jack Habib; Miriam Hirschfeld (2003). Key Policy Issues in Long-term Care. World Health Organisation. p. 78. ISBN9241562250. Retrieved 11 March 2014.
^ abcNolte, Ellen; Martin McKee (2008). Caring For People With Chronic Conditions: A Health System Perspective: A Health System Perspective. McGraw-Hill International. pp. 2, 4. ISBN978-0335233700. Retrieved 15 March 2014.
External linksedit
- American Hospital Association Chronic Care Management
December 15, 2023
chronic, care, refers, medical, care, which, addresses, existing, long, term, illness, opposed, acute, care, which, concerned, with, short, term, severe, illness, brief, duration, chronic, medical, conditions, include, asthma, diabetes, emphysema, chronic, bro. Chronic care refers to medical care which addresses pre existing or long term illness as opposed to acute care which is concerned with short term or severe illness of brief duration Chronic medical conditions include asthma diabetes emphysema chronic bronchitis congestive heart disease cirrhosis of the liver hypertension and depression Without effective treatment chronic conditions may lead to disability The incidence of chronic disease has increased as mortality rates have decreased 1 It is estimated that by 2030 half of the population of the USA will have one or more chronic conditions 2 According to the CDC 6 out of 10 adults in the U S are managing at least one chronic disease and 42 of adults have two or more chronic conditions 3 Conditions injuries and diseases which were previously fatal can now be treated with chronic care Chronic care aims to maintain wellness by keeping symptoms in remission while balancing treatment regimes and quality of life 1 Many of the core functions of primary health care are central to chronic care 4 Chronic care is complex in nature because it may extend over a pro longed period of time requires input from a diverse set of health professionals various medications and possibly monitoring equipment 5 Contents 1 Policy making 2 Challenges 2 1 Multiple conditions 3 Approach 4 See also 5 References 6 External linksPolicy making editAccording to 2008 figures from the Centers for Disease Control and Prevention chronic medical care accounts for more than 75 of health care spending in the US 1 In response to the increased government expenditure in dealing with chronic care policy makers are searching for effective interventions and strategies These strategies can broadly be described within four categories These are disease prevention and early detection new providers settings and qualifications disease management programs and integrated care models 6 Challenges editOne of the major problems from a health care system which is poorly coordinated for people with chronic conditions is the incidence of patients receiving conflicting advice from different providers 2 Patients will often be given prescriptions for medication that adversely interact with one another One recent study estimated that more than 20 of older patients in the USA took at least one medication which could negatively impact another condition 7 This is referred to as therapeutic competition Effective chronic care requires an information platform to track patients status and ensure appropriate treatments are given 8 There is a recognised gap between treatment guidelines and current practice for chronic care 9 Individualised treatment plans are critical in treating chronic conditions because patients will place varying important on health outcomes For example some patients will fore go complex inconvenient medication regimes at the expense of quality of life 9 Multiple conditions edit One of the greatest challenges in this field of health care is dealing with the co existence of multiple long term conditions also known as multimorbidity 5 There are few incentives within current health care systems to coordinate care across multiple providers and varying services 2 A 2001 survey by Mathematica Policy Research found that physicians feel they have inadequate training to deal with multiple chronic conditions An increase in the number of chronic conditions correlates with an increase in the number of inappropriate hospitalizations 2 Self management can be challenging because recommended activities for one condition may be made difficult because of another condition 9 Approach editThis section needs additional citations for verification Please help improve this article by adding citations to reliable sources in this section Unsourced material may be challenged and removed March 2014 Learn how and when to remove this template message This section possibly contains original research Please improve it by verifying the claims made and adding inline citations Statements consisting only of original research should be removed March 2014 Learn how and when to remove this template message Chronic care is a patient based approach to provide chronically ill patients with the knowledge and resources to help them better understand their conditions and to help them to adhere with treatment for better outcomes Chronic care patients may require the services of a variety of care providers including dietitians nutritionists occupational therapists nurses behavioral care pain management surgery and pastoral care Working in collaboration with the patient the chronic care provider coordinates care these and other specialist providers Additionally the patient may require palliative or hospice care especially at end of life See also edit nbsp Medicine portalChronic painReferences edit a b c Larsen Pamala D 2011 Chronicity In Lubkin Ilene Morof Larsen Pamala D eds Chronic Illness Impact and Intervention Jones amp Bartlett Publishers pp 3 4 ISBN 978 0763799663 Retrieved 10 March 2014 a b c d Gerard Anderson 2010 Chronic Care Making the Case for Ongoing Care Robert Wood Johnson Foundation Retrieved 14 March 2014 Chronic Diseases in America CDC CDC Retrieved 16 November 2020 Kane Robert L Reinhard Priester Annette M Totten 2005 Meeting the Challenge of Chronic Illness JHU Press p 93 ISBN 0801882095 Retrieved 15 March 2014 a b Ellen Nolte Cecile Knai Martin McKee 2008 Managing Chronic Conditions Experience in Eight Countries WHO Regional Office Europe p 2 ISBN 978 9289042949 Retrieved 11 March 2014 Busse Reinhard Miriam Blumel David Scheller Kreinsen Annette Zentner 2010 Tackling Chronic Disease in Europe Strategies Interventions and Challenges WHO Regional Office Europe p 3 ISBN 978 9289041928 Retrieved 11 March 2014 Lorgunpai Songprod Jonathan Grammas Marianthe Lee David S H McAvay Gail Charpentier Peter Tinetti Mary E February 25 2014 Potential Therapeutic Competition in Community Living Older Adults in the U S Use of Medications That May Adversely Affect a Coexisting Condition PLOS ONE Public Library of Science 9 2 e89447 Bibcode 2014PLoSO 989447L doi 10 1371 journal pone 0089447 PMC 3934884 PMID 24586786 Brodsky Jenny Jack Habib Miriam Hirschfeld 2003 Key Policy Issues in Long term Care World Health Organisation p 78 ISBN 9241562250 Retrieved 11 March 2014 a b c Nolte Ellen Martin McKee 2008 Caring For People With Chronic Conditions A Health System Perspective A Health System Perspective McGraw Hill International pp 2 4 ISBN 978 0335233700 Retrieved 15 March 2014 External links editAs good as it gets Chronic care management in nine leading US physician organisations American Hospital Association Chronic Care Management Retrieved from https en wikipedia org w index php title Chronic care amp oldid 1146388665, wikipedia, wiki, book, books, library,
