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Tuesday, December, 02, 2008

Working Harder, Spending Smarter, and Doing the Right Thing

by  Jane M. Martin
Thursday, February 21, 2008
Jane M. Martin
Jane M. Martin
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Jane M. Martin is a respiratory therapist with over twenty-five...

Jane M. Martin

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We need leadership that is focused to a much greater degree on Chronic Disease Management. Effective chronic disease management greatly reduces health care costs and helps people live healthier, happier, more independent lives.

 

If you saw somebody struggling day after day with a debilitating chronic illness and had in your power a way to help that person live a fuller, healthier life, you'd offer the needed help without hesitation, wouldn't you? Sure you would! But when it comes to providing funding for programs that educate and support those who have chronic disease, our government falls far short.

 

People these days are living longer with chronic disease and they are spending more years in the health care system, consquently putting a greater economic strain on that system. In her book, The Chronic Illness Experience, Cheri Register says, "No longer illnesses to die of, but still not thoroughly curable, they have become illnesses to live with."

 

With proper chronic disease management, patients learn to take care of their health, empowered to remain as stable as possible, independent and at home, with as few visits to the emergency room and in-patient hospital stays as possible.

 

On the other hand, when a chronic disease is not well managed, patients are more likely to develop crisis episodes, or acute exacerbations, requiring expensive emergency and in-patient care. For those working in healthcare, this is referred to as the revolving door. Patients come into the hospital in a crisis, and they are very ill. They are given excellent care and become well enough to return home. They return home, however, with little or no instruction on how to prevent another episode, only to fall ill again and return to the hospital with the same problem for more of the same expensive treatment. Unfortunately, this method of care, such that it is, is the status quo. Can we do better? Yes, we can. And we actually do, but we do it on a relatively small scale with little or no support from the government or Medicaire.

 

Let's talk for a moment about two major chronic illnesses that cost our health care system, and us as taxpayers, a lot of money when not effectively managed, and save a lot of money when they are! These are COPD (Chronic Obstructive Pulmonary Disease which is an umbrella term for emphysema and chronic bronchitis, sometimes with a component of asthma) and CHF (Congestive Heart Failure, or sometimes called Heart Failure). Both of these disorders, when poorly managed, can require severe, acute illness, overnight hospital stays - commonly several within one year. But with proper education and support, people with COPD or CHF can lead full, relatively healthy and independent lives, greatly reducing high utilization and costs.

 

There are programs out there that are working. In spite of an abysmal lack of funding, many organizations already have programs in place. Imagine what could be done if programs were funded. More organizations would have programs with patients involved in learning how to gain the strength, knowledge, and confidence to help themselves effectively manage their chronic illness at home and prevent expensive hospitalizations. Sound idealistic? Those of us working in the trenches know it is not. It is real and it works!

 

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