According to a recent report out of John Hopkins University, “people with chronic conditions account for 88 percent of all prescriptions filled, 72 percent of all physician visits, and 76 percent of all inpatient stays.”
Chronic conditions are those which last longer than a year, limit activities of daily living and may require ongoing medical care. The report cites the usual offenders: “hypertension (26 percent of non-institutionalized people with chronic diseases), chronic mental conditions (22 percent), respiratory disease (18 percent), arthritis (13 percent), heart disease (12 percent), eye disorders (10 percent), asthma (10 percent), cholesterol disorders (9 percent), and diabetes (9 percent).”
Clearly, chronic conditions impact the elderly more significantly than other patient populations since they are likely to have more than one chronic illness. “On average, people with only one chronic condition see three different physicians and fill six prescriptions a year.” But people with multiple chronic conditions (usually the elderly), have “significantly more physician contact and are more likely to be hospitalized each year than those with only one chronic condition,” says the report.
“People with five or more chronic conditions have an average of almost 15 physician visits and fill almost 50 prescriptions per year.” If you add dementia to the list of chronic illnesses and the elderly who live alone are likely to be victimized by the system. Incidents of fragmented care and “polypharmacy,” are the rule in unsupervised elder care, not the exception.
It is clear that in order to better meet the needs of our aging population with multiple chronic illnesses, the current health care system must be reoriented from acute, episodic treatment to a system that provides ongoing care management in home and community- based care.
Until that time comes, there will be a critical and long term need for elder care advocacy and chronic care management in a health care system that remains tooled to the acute model of care.