33241 - Creating Models for Health Care Delivery that...

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Unformatted text preview: Creating Models for Health Care Delivery that Address Chronic Disease Linda Siminerio, PhD Senior Vice President, IDF University of Pittsburgh Diabetes Institute Associate Professor School of Medicine Presentation Objectives: Describe the Problem and Urgency Present the Chronic Care Model Report on the “Pittsburgh Regional Initiative for Diabetes Education (PRIDE)” Present the Innovative Care for Chronic Diseases Model Highlight Global Projects Diabetes Worldwide Estimated number (in Millions) of people with diabetes, worldwide:* Increase in deaths from diabetes over next 10 years:† India 35% The Americas 80% the western Pacific and eastern Mediterranean regions 50% Africa >40% * Diabetes Prevalence. International Diabetes Federation, 2003. †Preventing Chronic Diseases: a vital investment, World Health Organization, 2005. 1985: 30 million 1995: 135 million 2003: 194 million 2025: 330 million 50 100 150 200 250 300 350 1985 1995 2003 2025 US Diabetes Facts US Diabetes Facts 20% increase past 20 yrs 70% increase 30-39 yr. age range 1 in 3 children born in 2003 will get diabetes Type 2 in children is increasing 14 million lost work days Annual costs -- $132 billion 1 8 . 2 2 0 . 8 5 2 1 0 2 0 3 0 4 0 5 0 Million Million 2003 2003 2005 2005 Pre-diabetes Pre-diabetes Epidemiologic Transition Non-Communicable Disease Infectious Disease Epidemiologic Transition Mortality Rates More information available at http://www.pitt.edu/~super1/lecture/lec0022/007.htm Omran, A. The Epidemiologic Transition: A theory of the epidemiology of a population change. Milbank Q. 1971:49:509-538. Organization of Health Care (What it should be) Evidence-based, planned care Clinical Guidelines Reorganization of practice (team approach) Includes ancillary professionals with the patient as the most important member Attention to patient needs (information) Counseling, education, information feedback Access to clinical expertise Patient and provider education, access to spets Supportive information systems Patient registries Provider feedback on preventive service utilization Organization of Health Care (What it is) Care is not necessarily based on evidence, but experience and training Seldom is there a team approach…care is mainly driven by the physician alone Paternalistic and directive approach with little attention to patients’ behavioral needs Limited access to diabetes spets Insurer limitations Reluctance of primary care referral Fragmented access Poor information systems No computers Poor tracking PARADIGM SHIFT ACUTE CARE CHRONIC CARE Focus: illness Care: fragmented Focus: prevention Care: coordinated Transition in Health Care Quality of Care for People with Diabetes in the United States 38 45.7 68.5 11 42.9 28.8 10 20 30 40 50 60 70 80 90 100 at least 1 HbA1c test HbA1c < 7% LDLc <100mg/dl SBP <140mmHg...
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This note was uploaded on 02/26/2012 for the course PHARM 210 taught by Professor Staff during the Fall '10 term at Rutgers.

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33241 - Creating Models for Health Care Delivery that...

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