Tara Penrod
HCM-340 Healthcare Delivery Systems
Southern New Hampshire University
December 15, 2019
A gap in quality related to care coordination for
... [Show More] individuals with chronic illnesses is
becoming a growing concern. Chronic illnesses are the leading cause of healthcare expenditures
with heart disease, cancer, stroke and depression being the largest contributors. In 2002,
noncommunicable conditions and mental disorders accounted for 47% of the global burden of
disease and it is projected to increase by 60% by 2020 (Shahady MD, 2006). There are several
factors contributing to the gap in quality that ultimately affect a person’s progress and over all
betterment of their health.
The failure to receive suitable healthcare can fall on both quality and access. In a patient
survey, it was reported 33-49% were not given advice on health risk behaviors and 47-67% were
not asked for their ideas or opinions on treatment options (Epping-Jordan, J E. 2004). It is
essential to create a system of care, instead of an individual health provider, to achieve a positive
outcome. Utilizing evidence-based treatment practices, regular follow-up, and implementing a
support system will give patients with chronic conditions a greater outlook and opportunity for
improved quality of life. Open communication and allowing involvement with patient
perspective towards their own care will greatly decrease issues of non-compliance.
In the healthcare setting it is easy to place blame on the patient for not making
improvements to their condition. Frequently it is documented by medical professionals with
claims of the patient being non-compliant with treatment or refusal to make necessary lifestyle
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changes as well as nonadherent of medical guidelines. But, nearly 40% of those with chronic
conditions did not receive adequate health care they needed to improve their outcomes. Of the
care provided, 20% was deemed clinically inappropriate. So, while in some cases noncompliance
is very true, in others the blame falls on the healthcare system and its providers. If
we continue to place blame on the patient, we will find solutions to their care will be limited
which in turn results in poorer health and more frequent hospitalizations.
With the expanding growth in chronic conditions the healthcare systems are not equipped
well enough to meet these demands. In 2005, 133 million Americans had at least one chronic
condition (Bodenheimer, 2009). Those over age eighty-five have the highest population with
multiple chronic illnesses and is expected to grow from five million to twenty-one million in
2050 (Bodenheimer). In order to provide higher quality of care at a lower cost, evidence suggests
using a multidisciplinary team rather than individual clinicians or specialists. Medicare is in the
process of creating and implementing disease-specific programs designed to improve health
outcomes without increasing the costs for treatment. Medicaid has also started to implement care
coordination programs with the focus being on self-management support and nurse casemanagement.
Other federal and private sector programs are following Medicare and Medicaid’s
lead with also developing disease management programs.
Person- and family- centered care (PFCC) can be defined as “providing care that is
respectful of, and responsive to, individual patient references, needs and values, and ensuring
that patient values guide all clinical decisions.” (IHI, 2001). Opening the communication
between clinician and patient can improve the [Show Less]