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

Morgan, Matthew; Zamora, Nicholas E.; Hindmarsh, Michael

doi:10.12927/hcpap.2007.18992

Cited by 53 publications

(49 citation statements)

References 7 publications

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“…The benefits of putting extra government resources into providing surgery (increasing supply) is questionable in the absence of a parallel comprehensive strategy and funds to reduce the volume of patients needing surgery (reducing demand). 7 Such a strategy could include providing incentives for primary care providers to manage chronic arthritis, improving access to physiotherapy, and reducing the prevalence of obesity.…”

Section: Discussionmentioning

confidence: 99%

“…Some people suggest that the system is designed to address acute episodes and lacks the necessary funding and structure to prevent and address chronic disease. 7 Historically, gaps in the system that affect people with arthritis have included shortages of orthopaedic surgeons, 8 insufficient access to physiotherapy, [9][10][11][12] and care that does not follow best practice guidelines. 13,14 For example, through research in Ontario, Glazier and colleagues [15][16][17] found that arthritis management provided by primary care physicians has been sub-optimal, with low use of options such as exercise, low rates of referral to other health care providers, and a lack of comprehensive recommendations for therapy.…”

mentioning

confidence: 99%

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Patients' Perceptions of Navigating “The System” for Arthritis Management: Are They Able to Follow Our Recommendations?

Cola

Juma

Kennedy

et al. 2014

Physiotherapy Canada

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Purpose: To understand whether a visit to a Hip/Knee Arthritis Assessment Centre (AC), where non-surgical candidates with arthritis are directed toward community resources and provided with a conservative treatment ''prescription,'' contributes to patients' self-management and ability to access community resources. Methods: A purposive sample of non-surgical patients was contacted 3-10 months after their AC visit. Three focus groups (n ¼ 20) and 20 semi-structured telephone interviews were conducted. Transcripts were systematically coded and analyzed using a qualitative descriptive research methodology. Results: While participants generally reported that the AC visit improved self-management, analysis identified an emergent theme about the inadequacy of conservative management in general, subdivided into two sub-themes related to (1) limited access to high-quality, non-surgical treatment, such as physiotherapy and (2) health care providers' attitudes and approaches, which do not embrace chronic disease prevention and management. Conclusions: An AC visit contributes to arthritis self-management; however, the current health care system does not adequately support conservative treatment of chronic conditions. Treatment guidelines need to be tailored to the local health care context in which they are applied.Key Words: disease management; health services accessibility; osteoarthritis; survey. RÉ SUMÉObjectif: Pour comprendre si une visite à un centre d'é valuation de l'arthrite de la hanche ou du genou, où des personnes qui ne sont pas candidates a grave; une intervention chirurgicale et ont de l'arthrite sont dirigé es vers des ressources communautaires et reç oivent une « ordonnance » portant sur un traitement de conservation, contribue à l'autoprise en charge par les patients et à leur capacité d'avoir accè s aux ressources communautaires. Mé thodes: On a communiqué , pendant 3 à 10 mois aprè s leur visite au centre d'é valuation, avec un é chantillon choisi à dessein de patients non candidats à une intervention chirurgicale. On a organisé trois groupes de discussion (n ¼ 20) et procé dé à 20 entrevues té lé phoniques semi structuré es. Les comptes rendus ont é té codé s systé matiquement et analysé s au moyen d'une mé thodologie de recherche descriptive qualitative. Ré sultats: Les participants ont signalé en gé né ral que les visites au centre d'é valuation amé lioraient l'autoprise en charge, mais l'analyse a dé gagé un thè me é mergent au sujet de l'insuffisance de la prise en charge conservatrice en gé né ral, subdivisé en deux sous-thè mes portant sur (1) l'accè s limité à un traitement non chirurgical de grande qualité comme la physiothé rapie et (2) les attitudes et les approches des fournisseurs de soins de santé qui n'adoptent pas la pré vention et la prise en charge des maladies chroniques. Conclusions: Une visite à un centre d'é valuation contribue à l'autoprise en charge de l'arthrite, mais le systè me de santé actuel n'appuie pas adé quatement un traitement conservateur des problè mes chroni...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Patients' Perceptions of Navigating “The System” for Arthritis Management: Are They Able to Follow Our Recommendations?

Cola

Juma

Kennedy

et al. 2014

Physiotherapy Canada

View full text Add to dashboard Cite

show abstract

“…Another source of patient information is telehealth systems. Several provinces have mature telehealth systems, including Ontario, Manitoba, Nova Scotia, Alberta and New Brunswick, and further expansion to northern and First Nations communities is underway (8).…”

Section: Cardiovascular Health Information In Canada: Current Status mentioning

confidence: 99%

Strengthening information systems for heart health in Canada

McFarlane

Wielgosz

2009

Canadian Journal of Cardiology

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“…Most of the energy directed at improving access and decreasing wait lists has focused on the supply side. Although these supply side strategies have been successful in reducing wait times in some areas, they are not sufficient on their own (38). Policies related to the demand side include setting clinical priorities for certain types of health care and managing patient expectations.…”

Section: Decreasing Demand For Carementioning

confidence: 99%

“…Another approach to altering demand is more long-term and is only briefly alluded to in various reports; it consists of illness prevention, health promotion and chronic disease management. A number of provinces have implemented chronic disease management programs and made revisions in primary care that have resulted in the reduction of wait times (38).…”

Section: Decreasing Demand For Carementioning

confidence: 99%

A commentary on access to cardiovascular services: Nursing roles and initiatives

Eastwood

Doucet

Estrella-Holder

et al. 2008

Canadian Journal of Cardiology

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

Cited by 53 publications

References 7 publications

Patients' Perceptions of Navigating “The System” for Arthritis Management: Are They Able to Follow Our Recommendations?

Patients' Perceptions of Navigating “The System” for Arthritis Management: Are They Able to Follow Our Recommendations?

Strengthening information systems for heart health in Canada

A commentary on access to cardiovascular services: Nursing roles and initiatives

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