Integration of Prevention into Chronic Disease Management Models of Care 1 Colter ,
1 Oelke ,
2 Clarotto ,
1 Caperchione D.
2 Arsenault
L. ND. A. C. 1University of British Columbia, Okanagan; 2Interior Health Authority
Background •Chronic disease is a major 1 issue •Most healthcare services emphasize caring for people already diagnosed with 2,3 chronic disease •Attention to primary 2,3 prevention is also needed •Little information available related to integration of primary prevention into chronic disease management services
Methods • Literature review: CINAHL, Cochrane, ERIC, Medline, Embase Selected articles are currently in review • Telephone interviews with providers and decision makers (N=19)
Next Steps
INTEGRATED MODELS OF CARE Current State: • Lack of emphasis on primary prevention to address chronic disease • Primary prevention not well integrated in chronic disease models • Lack of partnership between stakeholders
Prevention
Strengths:
• Upstream approaches
• Stakeholders have a desire to make change • Variety of services currently exist • New initiatives started (e.g., South Okanagan Similkameen Healthy Living Coalition)
• Comprehensive • Focuses on social determinants of health
CDM • Downstream approaches • Often episodic
• Tends to be Challenges: diagnosis • Lack of capacity for organizations, providers, and community members specific • Gaps in communication and missed opportunities for connections • Lack of monitoring and outcome measurement
Recommendations by Participants: • Improve communication and collaboration among all stakeholders • Change funding and payment structure for providers and programs • Endorsement from higher level decision makers • Conduct research related to integration of prevention and management
• Focus groups will be carried out to gain insight regarding community members’ perspectives
• An environmental scan will assess current practices locally, nationally and internationally
• Knowledge translation will occur in the form of presentations to stakeholders, briefing notes, publishing and conferences.
• A research planning meeting will be held in November
1.Health Council of Canada. (2011). How do sicker Canadians with chronic disease rate the health care system?: Results from the 2011 Commonwealth Fund International Health Policy Survey of Sicker Adults. Toronto, Canada: Author. 2.Barr, V. J., Robinson, S., Marin-Link, B., Underhill, L., Dotts, A., Ravensdale, D., & Salivaras, S. (2003). The Expanded Chronic Care Model: An integration of concepts and strategies from population health promotion and the Chronic Care Model. Hospital Quarterly, 7(1),73–82. 3.Kreindler, S.A. (2009). Lifting the burden of chronic disease: What has worked? What hasn’t? What’s next? Healthcare Quarterly, 12(2), 30–40. Images by luckyjimmy http://creativecommons.org/licenses/by/2.0/ and meddygarnet http://www.flickr.com/photos/meddygarnet