Managing Patient and System Complexities to Improve the Quality and Outcomes of Chronic Care

Excerpt

It is estimated that more than 120 million people in the United States have a chronic health condition, and 24% of those have three or more conditions.1 Overall, the veteran population is sicker and older than the general population, and a large proportion suffer from one or more chronic illnesses. For example, type 2 diabetes affects nearly 20% of veterans; ischemic heart disease is the most frequent indication for hospitalization in the VA; depression and schizophrenia account for more than 25% of VA’s total healthcare costs; and VA is the largest single provider of HIV care in the United States. Moreover, VA is now caring for a new generation of veterans who served during Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). Many of these veterans have suffered polytraumatic (multi-system/multi-organ) injuries, including traumatic brain injury and loss of limbs. These new veterans present our health care system with new challenges in terms of managing complex chronic care. Not only must VA provide the best care possible for veterans with multiple injuries, we also must help these young veterans learn to cope and live with chronic illness. …