We are proposing that Congress should develop state-wide programs to create better connections between supportive and clinical care delivery systems to improve the care of those with chronic conditions. Chronic illness and disability are the major cause of illness, disability, and death in the U.S. By 2010, 141 million Americans are projected to have a chronic condition. The following chronic diseases cause over two-thirds of all deaths each year: heart disease, cancer, stroke, chronic obstructive pulmonary disease, and diabetes. With proper care, the onset and progression of these diseases can be contained for many years.
Care provided in the current system is not cost-effective and often leads to poor outcomes for patients with chronic conditions. The medical care costs of people with chronic diseases amount to an estimated $1.7 trillion annually. People with chronic conditions are the heaviest users of health care services in all major service categories. They account for 72 percent of all physician visits and the majority of dollars provided my Medicare and Medicaid. People who have chronic conditions have trouble receiving quality care from the current health care system. Many have trouble accessing needed services such as medical specialists, mental health services, and in-home health care. Necessary services frequently extend beyond the clinical setting to supportive services such as home health care and personal assistance.
Chronic conditions require continuous care and coordination across various health care settings and providers. An improved system for caring for people with chronic conditions will ensure that a connection is made between clinical and supportive services, with an individual’s specific needs in mind, and that these services are readily available and affordable. Chronic care management helps patients monitor their progress and coordinate with experts to identify and solve problems they encounter in their treatment.
Moving to a care model that emphasizes care management will not be an easy task, but it has been done. Providers, policymakers, payers, and patients can work together to change the current health care system. Sutter Health in northern California is an excellent example of how this can be effectively done. Special monitoring devices allow patients to input a variety of health information into a database that is observed by a team of nurses. When a patient fails to check in to the monitoring system the care team is notified and a call is made to the house. The outcomes of this system have been significant. Emergency visits for those enrolled in the program are about half of those for general patients. Sutter saves approximately $600 a month for each member. And, perhaps most important, quality of care is improving. Nearly 80 percent of patients say they are better able to manage their chronic illness.
In the coming years, our health care system will devote increasing amounts of resources to the care for people with chronic conditions. Our reform proposal aims to make sure the chronically ill receive the care that is necessary for their daily functioning. This concept is important to ensure that these resources are spent wisely to maintain the health and functioning of this large segment of our population.
References:
Anderson, G., Knickman, J. (2001). Changing The Chronic Care System To Meet People’s Needs” Health Affairs, Vol. 20 No. 6, pp:146-159.
Anderson, Gerard, Robert Herbert, Timothy Zeffiro, and Nikia Johnson. (2004) Chronic Conditions: Making the Case for Ongoing Care. Retrieved March 10, 2009 from http://www.partnershipforsolutions.org/DMS/files/chronicbook2002.pdf
Bodenheimer, Thomas, Kate MacGregor, and Claire Sharifi. (2005).Helping Patients Manage Their Chronic Conditions. Retrieved March 13, 2009 from http://www.chcf.org/documents/chronicdisease/HelpingPatientsManageTheirChronicConditions.pdf
Center for Disease Control and Prevention. (2008) Chronic Diseases Overview. Retrieved March 9, 2009 from http://www.cdc.gov/nccdphp/overview.htm
Center for Disease Control and Prevention. (2008) Chronic Disease Press Room. Retrieved March 12, 2009 from http://www.cdc.gov/nccdphp/press/index.htm
Shi, Leiyu, and Singh, Doughlas A. (2008) Delivering Health Care in America: A Systems Approach. p. 460-462
A significant portion of the Healthcare Reform 2 section is relevent in the speech language pathology as well. If care could be brought to the individuals when school was not in sessions, positive advancement would increase tremendously. In turn, it may cut the cost of treatment in schools as a whole because they children may complete treament sooner without the setbacks caused by a three month lapse in therapy. This may not be the case for persons with severe physical or cognitive disabilities but for those whose treatment has been improved through incrimental therapy, it may shorten the duration of treatment in the long run.
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