People with chronic health problems are heaviest users of medical care, but system not organized to meet their needs

The heaviest users of the medical care system are the 128 million Americans who suffer from chronic health conditions, disabilities, or functional limitations. However, the system is not organized to meet their needs, according to a study conducted by the Johns Hopkins Bloomberg School of Public Health. People with more than one chronic condition, disability, or functional limitation have even greater difficulty receiving appropriate care. The study, which appears in the November/December 2001 issue of Health Affairs, suggests that better education of clinicians and changes in eligibility rules and health insurance coverage policies are needed to provide a system geared to the care for people with chronic health problems.

"Our health care system is oriented towards treating people with acute episodes, and not people with recurring problems or long-term health needs," says Gerard Anderson, PhD, professor of health policy and management and international health at the Johns Hopkins Bloomberg School of Public Health and national program director for Partnership for Solutions, an initiative to improve the care and quality of life of Americans with chronic health conditions.

"Millions of Americans suffering from chronic health problems, disabilities, or functional limitations must navigate a complex system of doctors, specialists, and caregivers with little help or coordination of care. Fundamental changes are necessary to design a health care system to meet the needs of those who use and need it the most," explains Dr. Anderson.

Using the Medical Expenditure Panel Survey (MEPS), Dr. Anderson and James Knickman, PhD, vice president for research and evaluation at the Robert Wood Johnson Foundation, estimated the number of Americans in 1996 suffering from long-term health problems and divided them into three categories; chronic problems, functional limitations,and disabilities. The researchers determined that 120 million Americans currently suffer

Contact: Tim Parsons or Ming Tai
Johns Hopkins University Bloomberg School of Public Health

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