The escalating problem of multiple chronic conditions (MCC) among Americans is now a major public health and medical challenge, associated with suboptimal health outcomes and rising health-care ...expenses. Despite this problem's growth, the delivery of health services has continued to employ outmoded "siloed" approaches that focus on individual chronic diseases. We describe an action-oriented framework—developed by the U.S. Department of Health and Human Services with additional input provided by stakeholder organizations—that outlines national strategies for maximizing care coordination and for improving health and quality of life for individuals with MCC. We note how the framework's potential can be optimized through some of the provisions of the new Patient Protection and Affordable Care Act, and through public-private partnerships.
...the uninsured rate has declined by 43%, from 16.0% in 2010 to 9.1% in 2015, and there is evidence of improvement with respect to both financial security and health status.1 In spite ofthis ...progress, public opinion of the ACA, according to Kaiser Family Foundation health tracking polls, was unfazed between 2010 and 2016, with roughly 40% of the public having a favorable view of the ACA and 40% having an unfavorable view (Figure 1; http:// kaiserf.am/2m3qjYp). In this issue of AJPH, Gollust et al. make the case that local media messaging about the ACA emphasized political over substantive reporting and reinforced a political polarization in public views of the ACA.2 Overall, there are likely numerous reasons for the enthusiasm gap in the ACA including significant partisanship, misinformation, an imperfect law, affordability issues with respect to cost sharing, plan cancellations, and the troubled rollout of the health insurance exchanges, just to name a few. With respect to the message, in spite of the law's focus on covering the uninsured through private health insurance exchanges and Medicaid expansion, should there have been much more attention given to the broader insurance benefits in the law that have an impact on a larger constituency? Polling has indicated that specific provisions of the law, such as the receipt of preventive services without cost-sharing, keeping adults younger than 26 years on their parents' insurance plans, and prohibiting insurance companies from denying coverage because of a person's medical history, were favored by a majority of Republicans and...
Current trends in US population growth, age distribution, and disease dynamics foretell rises in the prevalence of chronic diseases and other chronic conditions. These trends include the rapidly ...growing population of older adults, the increasing life expectancy associated with advances in public health and clinical medicine, the persistently high prevalence of some risk factors, and the emerging high prevalence of multiple chronic conditions. Although preventing and mitigating the effect of chronic conditions requires sufficient measurement capacities, such measurement has been constrained by lack of consistency in definitions and diagnostic classification schemes and by heterogeneity in data systems and methods of data collection. We outline a conceptual model for improving understanding of and standardizing approaches to defining, identifying, and using information about chronic conditions in the United States. We illustrate this model's operation by applying a standard classification scheme for chronic conditions to 5 national-level data systems. Although the literature does not support a single uniform definition for chronic disease, recurrent themes include the non-self-limited nature, the association with persistent and recurring health problems, and a duration measured in months and years, not days and weeks--Thrall. So far, many different approaches have been used to measure the prevalence and consequences of chronic diseases and health conditions in children, resulting in a wide variability of prevalence estimates that cannot be readily compared--van der Lee et al.
Optimizing US Global Health Funding Parekh, Anand
JAMA : the journal of the American Medical Association,
05/2023, Volume:
329, Issue:
17
Journal Article
PDF
