Chronic Disease

Question 1

What percentage of the population has 1 chronic disease?

Answer 1

45%

Question 2

What percentage of the population will have 1 chronic disease by 2020?

Answer 2

50%

Question 3

What percentage of the population with 1 chronic disease is over age 65?

Answer 3

88%

Question 4

What percentage of the total US health care expenditure in on chronic conditions?

Answer 4

75%

Question 5

What percentage of the US health care expenditure in on > 5 chronic conditions?

Answer 5

9%

Question 6

What does multi-morbidity risk correlate to?

Answer 6

Age
Education
Public health insurance

Question 7

Why is chronic disease prevalence rising?

Answer 7

The population is aging
Improved life expectancy (i.e. technology, aggressive treatment, better detection)
Increased prevalence of disease

Question 8

What is the likelihood that I will encounter a chronic disease if my parents had one?

Answer 8

85%, but not hard wired

Question 9

5 million Americans currently live with Alzheimers. How many by 2050?

Answer 9

16 - 20 million

Question 10

What are the stages of a chronic disease?

Answer 10

CIARIR
Crisis
Isolation
Anger
Reconstruction ("I am still me")
Intermittent depression
Renewal ("The new person")

Question 11

What were the findings of the NEJM study on chronic disease and depression?

Answer 11

No significant difference in mental health between individuals with a chronic condition and healthy age-matched controls as long as the diagnosis was stable and observed 4-6 months post-diagnosis.

Question 12

What were the findings of the study on COPD and anxiety?

Answer 12

1) Significantly higher likelihood of anxiety disorder
2) Significantly higher likelihood of panic disorder
3. QoL measures significantly lower for patients with COPD and anxiety than in non-COPD patients and COPD without anxiety

Question 13

What were the findings of the study on chronic disease and sleep?

Answer 13

There is a positive correlation between medical conditions and sleep disturbance.
Age alone (without the chronic illness) did not affect sleep.

Question 14

A strong patient-doctor relationship can positively affect:

Answer 14

Outcomes
Physiology
Overall function
Patient perception of well-being

Question 15

What percentage of the money Medicare pays physicians for patient care will have to demonstrate active management.

Answer 15

80%

Question 16

What were outcomes for patients with Congestive heart failure in a CCM?

Answer 16

1) Patients were more knowledgeable
2) Patients used recommended therapies (i.e. lipid-lowering & angiotensin-converting enzyme (ACE) inhibition therapy) more often
3) Patients visited the emergency department (ED) less often and experienced 35% fewer days in the hospital

Question 17

What were outcomes for patients with asthma in a CCM?

Answer 17

1) Patients were more likely to monitor their peak flows and have a written action plan
2) Patients perceive their quality of life improved

Question 18

What were outcomes for patients with diabetes in a CCM?

Answer 18

1) Patients experienced reduced risk of cardiovascular disease
2) For every forty-eight patients who received care from a redesigned practice, risk declined by one cardiovascular disease event.