Disease Management Programs for uninsured and underinsured, low-income patients with diabetes, asthma, and heart failure

jessievenegas Jessie Venegas — 10/01/2009

The Los Angeles County Department of Health Services has implemented disease management programs for uninsured and underinsured, low-income patients with diabetes, asthma, and heart failure who have historically not had access to this type of care and support. The program uses a proactive approach to identify and stratify the population into 3 groups based on their risk profile, with each group receiving services tailored to their needs. • The low-risk group: have a single, relatively straightforward chronic illness. • Medium-risk group: are individuals tend to be complex and/or have multiple chronic illnesses with a pattern of high resource use relative to their burden of illness. • The high-risk group: tend to have multiple chronic illnesses, such as heart failure, diabetes, asthma, and/or chronic obstructive pulmonary disease, along with multiple co-morbidities associated with these conditions The process of care has been restructured to improve coordination of services and to increase efficiency, with more than one-half of the patient contacts taking place over the phone or through remote monitoring. The program has reduced missed school days and emergency department (ED) and inpatient utilization for children with asthma and has improved glucose, lipid, and blood pressure control for patients with diabetes. Based on these successes, the program will be expanded to include adults with asthma and

Diabetes, Insuficiencia cardiaca, Asma, Fragilidad, pluripatología o polipatología y/o enfermedades crónicas complejas, Todas

Prevención
Promueve niveles adecuados de entendimiento por parte de la comunidad sobre el valor de la prevención , Se enfoca en desigualdades sociales
Tratamiento
Desarrolla los elementos básicos para un sistema de salud integrado , Provee o apoya políticas sanitarias para facilitar la planificación y la integración a nivel local y regional , Fortalece grupos colaborativos locales para proveer servicios integrales , Asegura la calidad óptima de los servicios sanitarios , Facilita la gestión por procesos , Enfatiza los cuidados de enfermos pluri-patológicos y frágiles

None

Progreso

ESTADOS UNIDOS

California

California

Los Angeles

Los Angeles, CA
Mapa de Prácticas

Comentarios


 Sin comentarios todavía. Añada un comentario en el formulario a continuación.