Health Care Reform and Chronic Disease

When TNA’s governing body met last spring, it directed this association to assist nurses in becoming acquainted with the major issues of health care reform. Managed care of chronic disease is one of them.

It’s true that quality health care has been able to eliminate many of society’s acute diseases. Consequently, we now live longer lives plagued with chronic diseases from genetic defects, environmental exposures or our own lifestyles. Consider the following:

• Cost of care is staggering: ¾ of the $2 trillion-plus that we spend on U.S. health care goes toward paying for chronic illness.
• Top chronic illnesses are:
  • Cardiovascular disease
  • Pulmonary disease
  • Cancer
  • Diabetes
  • Arthritis
  • High blood pressure
  • Depression
• There is a shift in care from hospital inpatient departments to ambulatory settings. This shift in care has caused the cost of out-of-pocket spending on chronic illness care to rise, often causing care to be reduced or dropped altogether.
• In 2005, 43.8% of U.S. citizens had one or more conditions that were classified as chronic:
  • 10.7% had two conditions
  • 13.3% had three or more
• There has been much hope for ‘Special Needs Plans’ which have the potential to coordinate Medicare and Medicaid benefits and services. This population of patients represents some of the highest cost and most complex health needs in the nation. While they offer hope, special needs plans are off to a slow start.
• The evidence of what works in chronic care management programs is under developed. Most evidence shows that using multi-disciplinary teams and in-person communication had fewer hospital re-admissions and re-admission days than routine care.

On the topic of managed care of chronic disease, TNA welcomes your comments and insights on chronic disease care. We ask, what can nurses offer?

Click here to read the TNA adopted resolutions on Health Care Reform.

Reference: Paez, Kathryn, Zhao, Lan and Hwange, Wenke; the Scope of the Problem, Health Affairs 28, no. 1 (2009); 15-25; 10.1377/hlthaff.28.1.15

 

 

Welcome to the Texas Nurses Association blog and thank you for visiting. Besides posting information and perspective from a nursing point of view we intend this TNA blog to be an interactive forum for nurses in Texas. We want your comments. We hope you’ll get involved in the discussions, the first of which will be health care reform.

We know, health care reform is a huge topic. Even though the extent of the reform is yet to be determined, many authoritative sources across the country already acknowledge that nurses should be the defining component of any change. That makes perfect sense to us.

What also makes sense is that nurses totally belong in the discussion. It is truly impressive that nurses have so much knowledge about what makes some health care work and other health care so ineffective. With this great wealth of knowledge, nurses could be so useful in the debate on health care reform.

Over the next period of time, TNA will post information – from a nursing perspective – on the major issues of health care reform. We encourage you to post your comments – so you can share with nursing colleagues what makes some health care work – and others not so much.