Current Critical Issue Report
Chapter 15: Chronic Care in America
This chapter explores issue associated with healthcare services provision to people with chronic illnesses in America. The number of the chronically ill patient is on the rise. The rise is occasioned by the increase in the number of the elderly people in the country. The chapter also explores that availability of healthcare for chronic illnesses in the country in terms of providers and institutions. It further explores various dynamics in regard to heath care for the chronically ill. The current state of chronic health care is a product of years of efforts and innovations. Chapter also examines the current state of chronic care and the development that brought it to its current state. The chapter also tries to forecast future developments in chronic care in terms of increase in the number of patients, technological advancements and new services, and the likely implications if the developments (Amara et al, 2003).
The chapter presents various issues that regarding chronic care. Chronic illness account for over 70% of the deaths in the country yet the cases of chronic illnesses are still on the increase. Despite this statistics the efforts to provide health care to the chronically ill are poorly coordinated due to their decentralize nature. Treating chronic illness is also expensive, Amara et al (2003) note that in 1996 alone $564 Billion was spent directly on handling chronic illnesses. According to Amara et al (2003) this constituted over 60% of the personal healthcare expenses of the chronically ill. Early detection which would have been helpful in treatment of the disease is also lacking. The population living with chronic illness is diverse and new trends may encourage more increase (Hoffman, Rice, & Sung, 1996). These are increase in the aging population; new treatments that have increase the life expectancy of the chronically ill and poor management of chronic illnesses. However, as Hoffman et al (1996) observe this people will have to bear with the high cost of treatment. Chronic care also suffers inadequate financing and insurance cover.
There are many people living with chronic illness. Some of the patients are able to live normally while others have been totally incapacitated by their illness. New care approaches have however, improved the lives of the chronically ill as well as improving their lifespan. Various players finance chronic care in the country however, the finance is till inadequate. Most of the financing is left to individuals. There also no longer solution to treatment of the chronically ill is not prioritized by most caregivers, and this further affects financing (Amara et al, 2003).
The future has a brighter side to the chronically ill. Development in healthcare and medication will improve the living conditions of the chronically ill. Early interventions will be explored and will reduce financial costs associated with chronic illnesses. Long term planning and financing will also be embrace thus reducing the financial shortage and further reducing the financial burden bared by individuals. This among other development will improve the quality of life of the chronically ill.
My thoughts on why this is a critical issue
Chronic care is critical issues since chronic people living with health conditions that they cannot treat but must continuously take medication in order to live a normal life. Failure to take medication could lead to death. The number of people with living with chronic illness is also increasing and is impoverishing many people since healthcare for chronic illness is expensive.
Chapter 16 Disease management
This chapter explores how to link management of disease with care of patients. It explores various diseases that are handled through this approach, how the management approach is being use to handle each of the diseases. The chapter further explores strengths and opportunities as well as buriers to this disease management approach. Last the forecast the future developments in disease management, and the pace of change in disease management (Amara et al, 2003).
As Amara et al (2003) note that there are various drivers and barriers, which affect adoption of disease management. Amara et al (2003) note that driver encourage the adoption of this approach while barrier discourage the adoption of the approach. The barriers noted are the fragmented nature of reimbursements characterized by unlimited contracts and limited time; some of the management plans are short-term in nature yet healthcare programs must be long-term in order to achieve a desired objective; the service delivery system is very fragmented, it is not user friendly and its poorly coordinated; physicians resists the approach since they are trained to deliver care individual to one patient at a time and find the approach quite foreign; patients are also indifferent over the approach since the find self-care, which is component of the management approach , to be boring; and the present technology is inadequate for handling patient through the management approach since it present problem when tracking individual patient records.
Disease management approach is one of the best approaches in handling diseases especially, chronic illnesses. The approach’s core component are identification of the subset with sickness or at risk groups, employing proper guidelines to handle those identified, incorporation of information systems to watch over patient practices and interventions, and measurement of patient intervention outcomes (Task Force on Community Preventive Services, 2002). Disease management is designed to pool together resources for improve healthcare. As a result healthcare can be continently provided to a number of patients at the same time thus reducing the cost incurred in treating or caring for chronic disease (Amara et al, 2003). The despite a number of barriers the approach is has several incentives that act as driving force that are likely to make the approach more acceptable in future.
The approach should be embraced since it confers numerous benefits both to healthcare management and to the patients. The most notable benefits is the reduction of costs uncured by both the care providers and the patients. Healthcare is very expensive patient stand to gain from this approach especially the patient of chronic illnesses which are financially demanding. This management approach holds great potential and should be encouraged.
My thoughts on why this is a critical issue
Management in healthcare is important influences that services patients receive. Proper management deliver dependable healthcare service while poor managed delivers low quality services. In this regard disease management is critical since it could positively influence the service given to patients and the expenses incurred in provision of the services.
Chapter 17 Health behaviors
This chapter explores patient behaviors and health. Various behaviors affect human health in different way. The chapter explores behaviors associated with alcoholism and drug abuses in the U.S. Alcoholism and drug abuse are causes of many preventable ailments. The chapter also explores how to prevent injuries especial from Guns and the effects of tobacco on the body. The chapter is bases of studies conducted since 1993 and shows that there are many health conditions that are a product of behaviors.
There are various behavioral issues that are presented in this chapter that influence human negatively. These include alcoholism and drug abuse which being about addiction and other dangerous behaviors. Alcoholism and drug abuse leads accidents leading to unintentional; disability, morbidity and premature mortality; harm to fetus in pregnant women; exposes one to unsafe sex and venereal infections; disruption of families; and sexual assault, domestic violence, suicide and homicide. Guns and tobacco are also explored (Amara et al, 2003). Guns cause numerous injuries and deaths in America on innocent victims than any other place on earth (Mokdad, 2004).
Alcohol and drug abuse is the most common self destructive behavior (Mokdad, 2004). Many people indulge in alcohol in the country from teenagers to adults. However, drug abuse is high in people of the ages between 18 and 25. Youth consume more marijuana and cocaine that other age group and their rate of initiation into drug consumption is high. Drugs and alcohol have negative effects to human health and lead to activities that further endanger the health and life of consumers, their families and friends. Fire arms also cause numerous injuries on people. It is estimated that nearly 40% of American homes have firearms, 32, 436 people died in 1997 from gun related causes (Amara et al, 2003). Gun injuries run across the age groups although most of the victims are young males from minority groups. Guns are used in homicides, suicides and sometimes people loose lives due to unintentional shootings. On the other hand, tobacco claims about 400, 000 people yearly. Unfortunately, consumption of alcohol, drugs, tobacco and illegal use of guns is not about to stop, in fact, forecasts show that they will raise.
Given the negative impacts brought about by drugs, alcohol and tobacco it is necessary to reduce consumption of the drugs. This is the best way to reduce negative impacts associated with the drugs. Also surveillance on fire arms and control is also important. This will reduce the number of death associated with illegal use of guns.
My thoughts on why this is a critical issue
Human health is a product of human behavior. Negative behavior leads to negative health, while positive behavior leads good health. This necessitated the need to control of negative behaviors in order to reduce negative behavior associated with negative health.
Amara, R et al. (2003). Health and health care 2010: the forecast, the challenge. Princeton NJ: Jossey-Boss
Hoffman, C., Rice, D. and Sung, H. (1996). Persons with Chronic Conditions: Their Prevalence and Costs [Abstract]. Journal of the American Medical Association; 26(18):1473–1479.
Mokdad, A. H. (2004). Actual Causes of Death in the United States, 2000. Journal of American Medicine Association. 291(10):1238-1245.
Task Force on Community Preventive Services. (2002). Recommendations for Healthcare System and Self-Management Education Interventions to Reduce Morbidity and Mortality from Diabetes. American Journal of Preventive Medicine. 22(4); p10-15