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opinion matters 9/30/05 12:39 Page 46
OPINION MATTERS
The global chronic care epidemic
and international expansion of
disease management programmes
WARREN E TODD, MBA
EXECUTIVE DIRECTOR, INTERNATIONAL DISEASE MANAGEMENT ALLIANCE
As hospitals around the world struggle to respond to
increasing demands on their capabilities from
tsunamis, the epidemic HIV/AIDS crisis, war
casualties and starvation in developing countries, another
global crisis is rapidly brewing. As suggested by the World
Health Organization, chronic disease promises to be “the
epidemic of the 21st century.”
While this near-term crisis threatens the basic economic
structure of both developed and developing countries, the
unhealthy lifestyles and global proliferation of obesity in our
younger population poses an even great threat as the “next
generation/wave” of chronic disease sufferers will emerge
decades sooner than historical demographics would
anticipate. Truly we have bi-modal healthcare crisis as
depicted in Figure 1. In short, today’s obese society will
likely become the next generation of chronic disease
sufferers and “hit our systems” in their 30s and 40s versus
over age 50 and expanded life expectancy can extend our
current near term challenge.
Our immediate short term
threat is of course that of
aging/chronic disease. This crisis
is literally “at our doorstep.”
This “Opinion Matters” will
deal only with the status of
disease management around the
world. Future articles may in fact
address the second crisis of
obesity and lifestyle erosion
around the world.
What is disease management?
There remains considerable
confusion, even today, concerning
this question. In many countries,
healthcare leaders confuse disease
management with disease
prevention. Very simply, disease
management is about the
prevention of the exacerbations
of disease post-diagnosis while
Next
Generation
Obesity
Prevention
& DM
wellness and prevention are about the actual prevention of
the disease. An accepted definition of disease management
as developed by the Disease Management Association of
America and accepted by all three United States
accreditation organizations is indicated below.
Definition: Disease management is a system of
coordinated healthcare interventions and communications
for populations with conditions in which patient self-care
efforts are significant.
Disease management:
➜ supports the physician or practitioner/patient
relationship and plan of care;
➜ emphasizes prevention of exacerbations and
complications utilizing evidence-based practice
guidelines and patient empowerment strategies, and
➜ evaluates clinical, humanistic, and economic
outcomes on an going basis with the goal of
I N N O V A T I O N
Boomers
Chronic
Disease
Disease
Management
& Prevention
18 -50 Age Group 50 - 90 Age Group
Figure 1: Bi-modal healthcare crisis
?
Life
Expectancy
46 | World Hospitals and Health Services | Vol. 41 No. 3