Chronic Condition Management

According to the U.S National Centre for Health Statistic a chronic disease is one that is very persistent and last for more than three months. These diseases usually are not prevented by any forms of vaccines nor cured through medication. They are mainly caused by health damaging behavior such as smoking, lack of physical exercises, unhealthy eating habits and other poor human lifestyle habits. Chronic illnesses are mainly associated with age. Amongst the leading chronic diseases include cardiovascular diseases such as strokes and heart attacks, cancer such as colon and breast, obesity, arthritis, seizures, diabetes, mood disorders, musculoskeletal diseases, neurological, and respiratory diseases. The most commonly affected people are the older adults although some of these illnesses have started affecting the younger generation (Who and Consultation) [1].

According to the U.S Census Bureau, by 2012, the baby boomer population had reached about 77 million. The population is made up people who were born between the mid-1947 and mid-1965. By 2011, the first group of this population had turned 65 years old. Over 65 years old of this group made up about 43.2 million people by the year 2012. It is estimated that by 2020, 15% of the entire USA population will be made of the baby boomers generation (Myers) [2]. A 2013 report released by the National Centers for Disease Control and Prevention indicates that, about two-thirds of the population that make the over 65 years old age group are affected by some form of chronic illness. In treating these conditions, they are forced to devote most of their health care cost towards it (Myers). It is expected that the number of patients with chronic conditions will continue increasing since aging is a continuos process. This will mean that three will be an increase in the number of people being affected. It is important that the conditions be managed to ensure the costs are kept in check. This is because currently, out of the $3 trillion annual health care budget for the country, the chronic condition costs account for 75% of it. There is the need for care management and coming up with other means through which this budget will be controlled and ensure it does not rise in the coming future (Myers) [2].

Individuals suffering from chronic related illnesses requires adequate health care services. As outlined by Partnership for Solutions [3], the enourmously needed services include hospital care, prescription drugs, and physician’s visits. Health care expenditures have increased due to the increased number of patients. Therefore, they affect the country’s health plans forcing the federal government and employers to come up with ways to reduce the health care costs and use. Disease management is one of the ways through which this huge health care budget will be reduced and still better health care will be provided for the people (Bodenheimer) [4]. Medicare beneficiaries from a diabetes management program were able to improve the conditions of the enrollees. The program had about 6800 beneficiaries and they had high primary care visits. The enrollees were able to make very few visits to the hospitals and emergency rooms as compared to the non-enrollees. In a two-year period the average monthly cost per enrollee was $395 as compared to non-enrollee $503 (Sidorov et al.) [5]. With development of chronic disease management programs, the health of persons living with chronic disease will be improved and any cost they incur will also be avoided. Before coming up with these management programs, there is need to first identify the target population and how the patients will be enrolled. Costly chronic conditions such as coronary heart diseases, diabetes, arthritis asthma and heart failure should be the main focus of such programs. Individuals who suffer from multiple chronic illnesses should also be beneficiaries of such programs.

In making of these program, they can either be employer or government sponsored. Employer-sponsored programs though very rare are used in managing their workforce health. This is because they believe that with managing the diseases of their employees there is an improvement in worker productivity and reduced medical insurance. Medicaid disease management programs are on the rise in the U.S. These programs by the government have also played a role in reducing the health care costs and improving the health of the people. In the developing of these chronic disease management programs, they usually need for the individuals involved to commit a huge amount of their time and effort if they’re to improve their health. Patients should be motivated to enroll in the various programs. The compliance of patients to these programs is very low. This is because some of them feel that the health care plans set for them by the programs are oppressive and some also lack trust in them. Communication barriers between the patients and the providers at times affect the programs. This is mainly brought about by cultural differences which affect program outcomes (Adonmeit et al.) [6].

A “no-show” is the main disadvantage on chronic condition management. This is whereby a patient does not show up for a scheduled appointment with a health practitioner in the different heath programs and does not call to reschedule or cancel. These missed appointments by patients affect the management of the disease because chronic illnesses require a lot of vigilant assessment. This is to determine the progression of the disease (Gellad et al.) [7]. To reduce the “no-show” of chronic patients, the clinics and different private practices that manage the programs; should ensure they encourage their enrollees to leave behind contact information. This information should include; their personal phone numbers, email addresses and contact information from close family members that can easily reach them when they are unavailable

To ensure the disease management programs are effective in solving the menace cause by chronic illness in the society, there is need to come up with solutions that will contain any hindrances. The programs should be made up strong social services team members. These teams will comprise social worker and some community health workers. When these two work together, they will have the ability to strengthen the management of chronic illness. The medical social workers play an important role in these teams. They train, recruit and supervise the community health workers. These are individuals who work towards the promotion of health and nutrition within the community in which the people reside. They will also play a major role in promoting the wellness of individuals who suffer from chronic illness and cannot afford the cost. The government should also invest in community health workers for they are very successful in managing chronic disease among the low-income individuals. A study that was carried out in a Children’s Hospital Boston. They utilized community health workers is an asthma initiative program. This saw a 64% reduction in pediatric asthma related visits in the emergency department (Bramwell) [8].

In the managing of health care for patients with chronic illnesses, it is at time faced by ethical dilemma. These dilemmas do not revolve just around making the right decision during difficult times but also justifying it. Most of the chronic illness is as a result of one’s lifestyle habits. In solving these conditions, it will mean that they will have to change their lifestyle habits. This will be an infringement of their Right of freedom. All the citizens in the United States are protected by the bill of rights that allows them to choose whatever they want.

Chronic illness such as diabetes is bought about by consumption of excess facts and sugars. Obesity is also the cause of other chronic illness such as cardiovascular disorders, ischemic heart conditions and type 2 diabetes. In controlling of obesity, the government has to set tough laws that will prevent the selling of processed foods to people. These tough laws on junk food industries will result in other factors such as increased unemployment rates and a slow economic growth. This results from the industries having to reduce their operations thus laying down their workers. In controlling obesity, it will also require most employers to set compulsory physical exercise for their employees. This may amount to some form of discrimination by these employers. The obese employee will feel like they are being subjected to discrimination though the main aim of these programs is ensuring their health and wellbeing is being maintained at its optimum level.

It is indeed evident there is need to control and ensure chronic diseases are eradicated. This is because, with aging being a natural phenomenon, chronic illnesses will always be on the rise if they are not controlled. Most of this older generation is not working which will mean their health will have to be catered for by the government and insurers. This will affect the economy of the country as millions of dollars will be directed towards the treatment of this generation instead of developing the economy. These chronic illnesses are very preventable and prevention is always better then cures.