Chronic Illness a factor in differing health care proposals

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(Host) While there are many differences in the health care proposals in Montpelier, nearly all the plans have one idea in common. They would invest several million dollars into a new initiative to help people with chronic illnesses.

VPR’s Bob Kinzel reports:

(Kinzel) If you want to understand why there’s so much interest in chronic care these days, consider these sobering statistics: People with chronic illnesses account for eighty-three percent of all health care spending, they represent eighty-one percent of all hospital admissions and ninety-one percent of all pharmaceutical costs. It’s estimated that half of all Vermonters over the age of fifty have a chronic illness and almost ninety percent of the people over the age of sixty-five fall into this category.

The chronic care initiative is part of every health care reform package at the Statehouse, because there’s general agreement that it will be very difficult to control health care costs in the future without implementing major changes in services for patients with chronic illnesses. Kate Lorig is the director of the Patient Education Research Center at Stanford University, and is one of the leading authorities on chronic illness.

(Lorig) “Chronic disease is the number one problem in the United States, actually in the world today, which is very different than twenty years ago or thirty years ago, when we were dealing mainly with acute illness. And one of the large differences is that with chronic disease, the individual is very responsible for making day-to- day decisions.”

(Kinzel) Lorig says the Stanford model for chronic care includes several key components. It creates an electronic data information system for all patients, making it easier for doctors to provide appropriate treatment. And it sets up community based programs to provide patients with additional services.

Lorig says these services are the heart of the initiative. While patients are encouraged to discuss medical issues with their doctor, peer to peer programs are set up to encourage individuals to take a more active role in managing their health care.

(Lorig) “What we’re trying to do, is set up a program where patients can teach patients. But they do it from a very very, very detailed protocol. When you do this, when you have patients teach other patients self management skills, in the long run, they’re less concerned about their disease. They have less pain. They have less shortness of breath, they tend to be more physically active. So all the things that you’d want from a good self manager are actually happening.”

(Kinzel) Linda is a state employee who has had diabetes for about ten years. She asked that we not use her last name. She was very skeptical when she was asked recently to participate in a two-month workshop for diabetic patients:

(Linda) “Quite frankly, I just went just because they suggested I go. But going helped me to realize that there were other people, not just myself, in the same boat had the same problems, had the same issues and that it involved many parts of their life, not just their chronic condition. And so, as a result, I’ve started taking better care of myself, exercising more. I’m actually continuing the workshop. We’re going to be doing monthly meetings with people that were in my group. So it’s to make us more aware. And I think the group concept is a wonderful one.”

(Kinzel) Linda says she hopes to become a workshop leader to help expand the number of programs that are available in central Vermont.

For Vermont Public Radio, I’m Bob Kinzel in Montpelier.

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