Continuity of Care for Chronic Conditions

Continuity of Care for Chronic Conditions

Six in ten U.S. adults live with at least one chronic condition, and four in ten live with two or more chronic conditions. The ability to attend medical interventions and follow-up care for these diseases is crucial to their successful management. 

One study showed that patients with a propensity to miss appointments  were significantly more likely to have incomplete preventive cancer cancer screenings as well as worse results on indicators of chronic disease, such as hemoglobin A1c and low-density lipoprotein (LDL) levels.

The most common chronic diseases include the following:

This short NCMM video shows the importance of creating a business relationship with dialysis providers.

  • End-stage renal disease. More than half a million people in the U.S. live with end-stage renal disease (ESRD) and require renal replacement therapy to sustain life. Approximately 90% of these patients travel to a dialysis center three times a week for treatment; during dialysis a machine does the work that their now non-functioning kidneys used to do. Missing even one dialysis treatment can cause severe complications and jeopardize patient health. Many dialysis patients are dependent on public transportation or contracted medical transportation services in order to get to the dialysis facility.
  • Cancer. Treatment for cancer may begin with surgery and post-surgical appointments, often followed by some type of chemotherapy. Most chemotherapy treatments are given in repeating cycles lasting from 2 to 6 weeks each. The American Cancer Society offers a volunteer-based transportation program to patients.
  • Chronic heart and lung disease. Patients attend regular appointments with health care providers for disease education, medication management, and disease monitoring.
  • Diabetes. Patients attend regular appointments with health care providers for disease education, medication management, and disease monitoring.
  • Alzheimer’s disease and other debilitating old age-related diseases. When an individual reaches the stage where they need continual care, and they are not in a residential setting that provides that care, they and their family may turn to adult day care centers. These services are designed to provide care and companionship for older adults who need assistance or supervision during the day. There are two types of adult day care: adult social day care and adult day health care. Adult social day care provides social activities, meals, recreation, and some health-related services. Adult day health care offers intensive health, therapeutic, and social services for individuals with serious medical conditions and those at risk of requiring nursing home care. In all states, Medicaid pays for adult day care and/or adult day health care; Medicare does not, although a Medicare Advantage plan may. Adult day centers usually operate five days/week, and many provide their own transportation.

For further investigation . . .

National Center for Chronic Disease Prevention and Health Promotion

We know that most chronic diseases can be prevented by eating wellbeing physically active, avoiding tobacco and excessive drinking, and getting regular health screenings. CDC’s National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) helps people and communities prevent chronic diseases and promotes health and wellness for all.