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Challenges for Chronically Ill Patients
Health care today can be challenging to coordinate, especially in lower income, inner city populations, and for chronically ill patients. Patients with advanced chronic illnesses often have a difficult time organizing and keeping track of medical records, maintaining insurance providers, and receiving timely access to care. As a result, many chronically ill patients undergo reactive episodic care to temporarily cover up their problems.
Chronically ill patients often have numerous physicians, unnecessary ER visits and hospitalizations. They receive disjointed treatment from physician offices, hospitals, ERs, nursing homes, and home health agencies who often have poor to non-existent communication with each other. A solution for these recurrent issues is not likely any time soon, as both conventional Medicare and private insurances offer few tools or incentives for integration.
Primary care physicians in private practice or clinics often have 1,700 - 2,000 patients, making it virtually impossible to coordinate care. While there has been an increase of primary care in hospitals, or hospitalists, there has been limited follow-up once a patient is discharged. For more complex patients, there has been a growing dependency on nursing homes or skilled nursing facilities versus proactive community care.
With an aging population, high medical cost inflation, a federal Medicare program that’s going bankrupt, and no strategy for care of chronically ill patients, we are approaching a major crisis. We must re-focus attention on the doctor-patient relationship and population needs, rather than the habitual practices of those delivering care in institutional settings.