An Inconvenient Truth: A Sustainable Healthcare System Requires Chronic Disease Prevention and Management Transformation

Courtyard Group, University of Toronto, University Health Network.
HealthcarePapers 02/2007; 7(4):6-23. DOI: 10.12927/hcpap.2007.18992
Source: PubMed


Canada's initial success at shortening wait times will not transform our healthcare system unless it is matched with equal success in the prevention and management of chronic diseases. A growing body of evidence highlights the significant gap between recommended care and actual care received for those at risk for or living with chronic illnesses. This quality gap not only results in significant preventable morbidity and mortality but also lengthens wait times for healthcare services and threatens the sustainability of our healthcare system. A national strategy on chronic disease prevention and management (CDPM) that leverages the federal, provincial and territorial (FPT) response to wait times will not only transform chronic illness care but also help to ensure the sustainability of our healthcare system. We begin this paper by highlighting some of the facts behind this inconvenient truth. We then review and provide examples of several best practices in CDPM. We suggest that these best practices provide the foundation for a national CDPM strategy and argue that the FPT mandate for wait times be expanded to encompass CDPM and result in "care guarantees." We conclude with a high-level preliminary analysis of costs and benefits of this strategy to transform CDPM in Canada.

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    • "Within the health system, greater integration between and within existing chronic disease management and prevention strategies is one way to achieve change [25, 26]. However, the need for moving beyond incremental to transformative change for more effective chronic disease management is up for debate [27]. Application of models such as the Chronic Care Model, which incorporates multidisciplinary teams with well-informed, active patients within the wider community and health care context, may be helpful to improve health outcomes, while recognizing the complexity of the existing health system structure [28]. "
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