Chronic disease: the overlooked & understudied epidemic

Detroit, Mich. Feb. 24, 2000 -- According to the latest issue of the British Medical Journal, large employers and government payers of medical services looked to health maintenance organizations during the 1980's to control escalating health care costs. But by the 1990s, the "quick fixes" had run their course, and management of chronic conditions became the centerpiece for quality and cost control. In the United States, typical of industrialized countries, the four top chronic diseases (cardiovascular disease, cancer, chronic obstructive pulmonary disease and diabetes) together are responsible for 72 percent of deaths each year.

The British Medical Journal and its sister publication, the Western Journal of Medicine (covering the Pacific states of the U.S.) have both focused current special issues on the management of chronic disease. This week's special issue of BMJ addresses the unique demands that chronic illness makes on patients, families, and healthcare systems, and the effectiveness of interventions to meet these demands. Failure to meet these demands, most of them low-technology in nature, helps to explain why advances in the development of specific treatments have far outpaced reductions in morbidity and mortality. For example, despite dramatic improvements in clinical treatments for asthma, death and disability associated with the disease are at an all time high.

"Just as chronic disease control has developed into a distinct discipline in public health, so chronic disease management is now beginning to develop its own identity as an important component of health care," said BMJ's North American Editor, Ronald Davis, M.D.

Edward Wagner, M.D., Director of the W.A. MacColl Institute for Healthcare Innovation at the Center for Health Studies, Group Health Cooperative of Puget Sound, author and co-author of two articles and the special issue's lead editorial, emphasizes that each chronic illness should not

Contact: Ron Davis, M.D.
Center for the Advancement of Health

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