Integration of Prevention into Chronic Disease Management Models of Care L.
1 Currie, BA(c), 1University
ND.
1 Oelke,
PhD RN, & L. Bryant
of British Columbia, Okanagan;
2Interior
Background • • • • •
Chronic disease is a rapidly growing concern1 Focus on management and secondary prevention of chronic conditions rather than primary prevention2,3 Policy change, community development, and initiatives focusing on the determinates of health show the most promise3 Limited integration between community-based organizations, health authority services, and primary care A proactive approach to integration is needed
What is the current state of integration?
What challenges are experienced in integration?
What factors assist integration?
Methods • • •
Systematic literature review was conducted focusing on prevention in Chronic Disease Management (CDM) Environmental scan completed of current practices utilizing integrated prevention and CDM models of care Semi-structured interviews conducted with managers/providers involved in CDM and those involved in prevention services delivery Focus groups with community members completed
Funded by: The Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia
MSc
Health Authority Results
Benefits of Integration of CDM and Prevention?
•
2 MacLean
• Chronic disease places a heavy burden on the health care system • Prevention focus has shifted towards lifestyle and behavioural factors • Health education and marketing is not enough; those most in need of information are not receiving it • Narrow focus on specific diseases, populations, and settings • Lack of communication and effective team functioning • Fragmentation in services, gaps, and duplication • Physician engagement • Lack of awareness about available programs • Limited funding • Lack of evaluation and impact measurement • Builds community capacity • Reduces reliance on health care providers • Improved utilization of health care services • Reorientation of health care towards health promotion • Multidisciplinary teams • Expanding roles, expending reach • Multi-component targeted interventions • Effective communication • Cooperation and collaboration rather than competition • Consistent primary care model
Conclusion • • • •
There is a desire for a greater focus on prevention initiatives Linkages between prevention and CDM are necessary Need support from upper level decision-makers and policy-makers for successful integration It is essential to establish partnerships where all stakeholders are involved 1.Health Council of Canada. (2011). How do sicker Canadians with chronic disease rate the health care system?: Results from the 2011 Commonwealth Fund International Health Policy Survey of Sicker Adults. Toronto, Canada: Author. 2.Barr, V. J., Robinson, S., Marin-Link, B., Underhill, L., Dotts, A., Ravensdale, D., & Salivaras, S. (2003). The Expanded Chronic Care Model: An integration of concepts and strategies from population health promotion and the Chronic Care Model. Hospital Quarterly, 7(1),73–82. 3.Kreindler, S.A. (2009). Lifting the burden of chronic disease: What has worked? What hasn’t? What’s next? Healthcare Quarterly, 12(2), 30–40. Images by: AmazingAlmonds https://www.flickr.com/photos/71430589@N02/, meddygarnet http://www.flickr.com/photos/meddygarnet, and moonman82 https://www.flickr.com/photos/25830962@N06/