chronic disease

Question 1

What percentage of the generqal US populaiton has at least 1 chronic medical condition?

Answer 1

45% of the US populaiton has at least **1 **chronic medical condtion

50% by the year 2020

Question 2

What percentage of the elderly (65yrs+) has at least one chronic medical condtion?

Answer 2

88% of those 65yrs and older

Question 3

What percent of US health care expenditures go to chronic conditions?

Answer 3

75% of US health care expenditures go to treating chronic conditions

Question 4

Which group of pts with chronic illness consume the most health care, and are most difficult to treat?

Answer 4

Majority of medicare spending goes to treating pts with 5 or more chronic meidcal conditions

• These pts tend to be older, have less education and use public health insurance (medicaid)
• 3% of US GDP is spent on treating chronic disease
  
  • will increase to 9% of US GDP by 2030

Question 5

Why has there been an increase in the prevalence of chronic disease?

Answer 5

• increased life expectancy and aging populaiton increases the chance of a person developing chronic disease
• better detection and treatment of chronic disease (heart disease)
• new technologies to manage chronic disease in the long term
• increasing rates of obesity, diabetes, and heart disease associated with environmental and lifestyle changes

Question 6

What are the stages of chronic illness?

Answer 6

1. Crisis
2. isolation
3. anger
4. reconstruction (redefine identity)
5. intermittent depression
6. renewal (acceptance of illness)

Question 7

How does chronic disease impact sleep?

Answer 7

chronic illness negatively affects sleep

• Group age 55-84
• All had at least one of 11 different chronic diseases
  
  • 25% had major co-morbidity (4 or more)

Study found strong positive correlation between medical conditions and sleep disturbance

Question 8

How does the quality of the physican relationship affect people with chronic disease?

Answer 8

Good physican-pt relationship improves chronic disease management

Study found the following improve with a good Dr-pt relationship

–Outcome
–Physiology
–Overall function
–Patient perception of well-being

Question 9

Lost some physican behaviors influence postive outcomes in pts who have chronic disease

Answer 9

• Patient-centered behaviors
• Physician job satisfaction
• Number of patients seen per week
• Scheduling timely follow up appointments Tendency to answer questions
• Specialty
• Just giving out information has little impact
• Most important: being able to talk to my doctor

Question 10

Describe the chronic care model, and list some stats that indicate the model is working

Answer 10

Goals of the chronic care model

• increase pt access to support services beyond acute care provided by the physican
• use care coordinator who contacts pts with chronic illness to ensure compliance with treatment and is doing ok
• utilizes social workers to allow pt to access more comunity resources

​2009 health affairs study effectiveness of model

• pts spend 35% fewer days in hospital
• visit ER less

Question 11

Describe how compassion fatigue negatively impact physicans and nurses treating chronic illness

Answer 11

chronic illness which cannot be cured, exhausts physicians and nurses

Signs and symptoms of **compassion fatigue **are similar to those of burnout

• Doctors withdraw, work harder, feel hopless, feels exhausted emotionally and physically, experiances headaches, GI problems, depression ets..