One out of three Californians – 12 million people – has
a chronic illness such as diabetes, congestive heart disease or asthma, and almost half of
those have two or more chronic illnesses. Chronic diseases are disproportionately present
in minority and low-income communities, often those served by public hospitals and health
systems. These illnesses not only shorten life span, they disable people and degrade
the quality of life if not managed appropriately. Nationally, our health care system
does a poor job of caring for the approximately 100 million people with chronic illness;
for example, only 27% of people with hypertension receive adequate treatment.
Thanks to the commitment
and extra efforts of pioneers in primary care redesign across the CAPH membership, many more
Californians now have access to excellent care in our public hospitals and health systems.
Important strategies taken from the Chronic Care Model (CCM) include planned diabetes visits, disease-specific
clinics, electronic disease registries, and nurse case management.
During 2007 and 2008,
SNI is engaged in a $1 million-plus program to improve chronic disease care statewide in
21 public clinics statewide, from 10 CAPH public clinic networks. The program, Spreading
Effective and Efficient Diabetes Care in California’s Public
Hospital Systems (SEED), is funded by the California HealthCare Foundation.
Earlier
work implementing the Chronic Care Model in public hospital clinics was done with great success
in 2004 and 2005, through the SNI’s California Chronic Care Learning
Communities Initiative (CCLC).
In addition, the Agency
for Healthcare Research and Quality (AHRQ) has awarded a two-year,
$400,000 grant to the MacColl
Institute for Healthcare Innovation, SNI, and the RAND
Corporation to develop, implement, evaluate and disseminate
a toolkit to facilitate efficient and financially viable implementation
of the CCM in safety net organizations.
Set to begin in October 2006, the program will work closely with
the Santa Clara Valley and San Mateo Medical Centers to develop,
evaluate, and spread the tools to improve chronic care quality and
financial health in the safety net. |
