According to the CDC, almost half of all Americans have one or more chronic illnesses. For those age 65 or older, the figure is closer to 85 percent. To find out how the health care industry is doing when it comes to chronic illness care, a team including researchers from UC Berkeley, UCSF, and New York Cornell Weill Medical College conducted three national surveys of physician practices between 2007 and 2013.
The latest of these was a 40-minute phone survey conducted with 1,398 large, medium, and small practices nationwide. The analysis, “Managing Chronic Illness: Physician Practices Increased the Use of Care Management and Medical Home Processes”, led by Dr. James Wiley, professor at The Philip R. Lee Institute for Health Policy Studies at UCSF, was published in the January issue of Health Affairs.
The survey focused on the extent to which the practices have increased their use of patient-centered medical home (PCMH) processes in the care of patients with four major chronic illnesses: asthma, congestive heart failure, depression, and diabetes. The patient-centered medical home is a model of health care that focuses on prevention, wellness, and coordination of care for patients using a multi-disciplinary team of providers to improve the quality of care and reduce associated costs.
The team found relatively large increases over time in the overall use of evidence-based care management processes, across all practice sizes. They also found that larger practices use significantly more PCMH processes than do small and medium-size practices, even though large practices used fewer than half the recommended practices on average.
“While there has been consistent improvement over time in the use of evidence-based processes for caring for patients with chronic illness, there is great room for improvement,” says Dr. Stephen M. Shortell, director of CHOIR and co-author. “This is particularly true for the use of condition specific disease registries, nurse care managers, and approaches for increasing access to care. The pace of improvement will need to accelerate to meet the increasing needs of a growing population of people with chronic illness.”