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Living Well with Chronic Illness: A Call for Public Health Action
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The epidemic of chronic illness – which represents 75 percent of the $2 trillion in annual U.S. health care spending – is steadily moving toward crisis proportions, yet maintaining or enhancing quality of life for individuals living with these illnesses has not been given the attention it deserves. Longevity is no longer the only goal as more focus is placed on living a long and healthy life.
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Framing international trade and chronic disease
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There is an emerging evidence base that global trade is linked with the rise of chronic disease in many low and middle-income countries (LMICs). This linkage is associated, in part, with the global diffusion of unhealthy lifestyles and health damaging products posing a particular challenge to countries still facing high burdens of communicable disease. We developed a generic framework which depicts the determinants and pathways connecting global trade with chronic disease. We then applied this framework to three key risk factors for chronic disease: unhealthy diets, alcohol, and tobacco. This led to specific 'product pathways', which can be further refined and used by health policy-makers to engage with their country's trade policy-makers around health impacts of ongoing trade treaty negotiations, and by researchers to continue refining an evidence base on how global trade is affecting patterns of chronic disease.
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Understanding chronic non-communicable diseases in Latin America: towards an equity-based research agenda
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Although chronic non-communicable diseases are traditionally depicted as diseases of affluence, growing evidence suggests they strike along the fault lines of social inequality. The challenge of understanding how these conditions shape patterns of population health in Latin America requires an inter-disciplinary lens.
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The growing caseload of chronic life-long conditions calls for a move towards full self-management in low-income countries
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The growing caseload caused by patients with chronic life-long conditions leads to increased needs for health care providers and rising costs of health services, resulting in a heavy burden on health systems, populations and individuals. The professionalised health care for chronic patients common in high income countries is very labour-intensive and expensive. Moreover, the outcomes are often poor. In low-income countries, the scarce resources and the lack of quality and continuity of health care result in high health care expenditure and very poor health outcomes. The current proposals to improve care for chronic patients in low-income countries are still very much provider-centred.
The aim of this paper is to show that present provider-centred models of chronic care are not adequate and to propose 'full self-management' as an alternative for low-income countries, facilitated by expert patient networks and smart phone technology.
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An analysis of Liberia's 2007 national health policy: lessons for health systems strengthening and chronic disease care in poor, post-conflict countries
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Globally, chronic diseases are responsible for an enormous burden of deaths, disability, and economic loss, yet little is known about the optimal health sector response to chronic diseases in poor, post-conflict countries. Liberia's experience in strengthening health systems and health financing overall, and addressing HIV/AIDS and mental health in particular, provides a relevant case study for international stakeholders and policymakers in other poor, post-conflict countries seeking to understand and prioritize the global response to chronic diseases.
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Social participation and healthy ageing: a neglected, significant protective factor for chronic non communicable conditions
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Low and middle income countries are ageing at a much faster rate than richer countries, especially in Asia. This is happening at a time of globalisation, migration, urbanisation, and smaller families. Older people make significant contributions to their families and communities, but this is often undermined by chronic disease and preventable disability. Social participation can help to protect against morbidity and mortality. We argue that social participation deserves much greater attention as a protective factor, and that older people can play a useful role in the prevention and management of chronic conditions. We present, as an example, a low-cost, sustainable strategy that has increased social participation among elders in Sri Lanka.
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Health Reform: Meeting the Challenge of Ageing and Multiple Morbidities
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When the OECD was founded in 1961, health systems were gearing themselves up to deliver acute care interventions. Sick people were to be cured in hospitals, then sent on their way again. Medical training was focused on hospitals; innovation was to develop new interventions; payment systems were centred around single episodes of care.
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Consideration of Multiple Chronic Diseases in Randomized Controlled Trials
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Before approval of a new drug, the US Food and Drug Administration (FDA) requires phase 3 clinical trials demonstrating efficacy. Usually trials are conducted in homogeneous populations and rarely include individuals with multiple chronic conditions. In the United States, more than 50% of people with chronic conditions have 2 or more diseases. Twenty-eight percent of the population lives with multiple chronic conditions, including 2 of 3 older individuals. Multiple chronic conditions account for 66% of the country's overall health expenditures 2 and more than 95% of Medicare expenditures.
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Encuesta de Morbilidad Hospitalaria 2010
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La Encuesta de Morbilidad Hospitalaria (EMH), aunque no tan antigua como la de Defunciones, tiene también gran tradición en el INE. Se implantó en el año 1951 y desde entonces ha sido elaborada anualmente.
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Person-centered care - Ready for prime time
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Long-term diseases are today the leading cause of mortality worldwide and are estimated to be the leading cause of disability by 2020. Person-centered care (PCC) has been shown to advance concordance between care provider and patient on treatment plans, improve health outcomes and increase patient satisfaction. Yet, despite these and other documented benefits, there are a variety of significant challenges to putting PCC into clinical practice. Although care providers today broadly acknowledge PCC to be an important part of care, in our experience we must establish routines that initiate, integrate, and safeguard PCC in daily clinical practice to ensure that PCC is systematically and consistently practiced, i.e. not just when we feel we have time for it.
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