Gaps to Treatment for Chronic Illness

 If you have a chronic illness you are not alone, thee are 133 million people who are affected by a chronic illness within the United States every day. According to the National Health council 40% of Americans have a chronic illness. Nearly half of the 40% percent make up adults however and there is 8% of children who have a chronic illness (National Health Council). Even with all the research and theses statics there is still gaps within quality the care coordination for chronic illness. Many people cannot access and or do not have the access to the proper care that they need to be able to properly manage their chronic illness. This could be because of one not having health insurance or not having a provider that they need, a provider being out of their network, lack of providers within their area that can properly care for their illness. With this gap treatment and proper care is going missed and ultimately can result in an early death which could have been prevented if the proper care was accessible and provided.

 There are several gaps through-out the last decade that have impacted one’s ability to access the proper healthcare they need. Having health insurance is not just an undesired need or a waste of money it can ultimately be a necessary especially for one who has a chronic illness. In 2017 there were roughly 28.5 million people who did not have health insurance coverage. Many of the people who do not have health insurance for the simple fact of the cost of the insurance plans that are offered within their area or through their current employer. Another reason one could not have insurance would be the fact that they are in the United States illegally and not a United States citizen. Now just because you have health insurance it does not necessarily mean that doctors that one is going to see is within the network and that one is going to get the right care that they need. This is because most insurance companies now have specific qualification and certain restrictions within their policy that does not allow accessing specific care easily. This includes lab work, routine check-ups, cost of each visit which ultimately can lead to one not wanting to go see a doctor and seek care through emergency rooms and paying more in medical costs and not getting the proper medicines that are they need. 

 Another gap that has changed would be specific programs that have been implanted. Through-out the last several years there has been an increase with programs in the United States healthcare system that are designed to target the type of care coordination a patient gets. Whereas before specific programs limited one’s coordination in care and how one’s care was being treated. While all these types of programs are different, they all have one goal in mind and that is to be able to improve the disease and to minimize the cost of one’s healthcare needs. Those who have a chronic illness will see their primary care doctors more, need specific medications filled and could often times be hospitalized for long periods of times. Many people with a chronic illness are given specific medications that could lead to medications overlapping with each other causing a possibility of a mixed medication interaction, they end up having multiple doctors who often provide different diagnosis and repeating tests for lab work. This often can make it challenging for doctors to treat specific conditions as well as researchers when they are getting their data and policy makers to ensure they the correct information needed for their policies.

 What is a chronic disease? When thinking of a chronic disease many think it is cancer, however a chronic disease is not just cancer. Diabetes (including type 2), heart disease, mood disorders, COPD, Asthma and Arthritis are just some of the most common chronic illnesses (Medline Plus). Occupation, amount of household income, education and your racial background are all socioeconomic factors that contribute to the development of a chronic illness. One of the largest populations affected by a chronic illness would be, “People of color face higher rates of diabetes, obesity, stroke, heart disease, and cancer than whites. In the case of diabetes, the risk of being diagnosed is 77 percent higher for African Americans and 66 percent higher among Hispanics, than for whites. Asian Americans, Native Hawaiians, and Pacific Islanders are at twice the risk of developing diabetes than the population overall (Health affairs, 2017)”.  Studies show that those who live in the south and are African American had the highest rate of obesity, diabetes, blood pressure and stroke. They also found that they were not as active and did not eat fruits and vegetable regularly. Education levels could be lower than other in their areas that later results in lower income placing these individuals in a lower poverty area. Not being able to afford health insurance and not having the proper knowledge of how the health care coverage works, the knowledge of the importance of routine check-ups are all results of these studies.

 Many people are affected by socioeconomic factors on a day to day basis. Socioeconomics affects ones able to be able to access the care that they need, what kind of care that they need and how they receive the care that they need. Those who have a higher education are typically able to understand their chronic illness and are able to understand the care that is needed to treat their illness and be able to properly manage their treatment and illness as well. Those who are educated are also more than likely to be more willing to go along with their treatment that is required by their doctor. Whereas those who are not as educated will be hesitant and less proactive with their treatment plan. This could be simply because those who are not educated about the importance of maintaining a proper health feel like they are not receiving the proper care that they need and often times disregard their doctor’s instructions for at home care. Which in return requires more medical attention and more medical bills for someone who may already have a difficult time being able to afford the care in the first place.

 Patients are not just to blame for the gaps within the socioeconomic factors. The blame also has to do with the providers, the doctors and the insurance companies for one not being able to get, treat and manage their chronic illness. Previously providers and doctors use to focus on treatments used top end technology and the best medications however the last decade things have changed slightly when treating specific illnesses. Physicians have started to educate their patients about the importance of managing their illness by healthy diet, activity and managing specific medications. Another reason for the gap is the way physicians would often judge, stereotype or become bias towards their patient. That affects the way one feels like they are being treated by their doctor or their nurse. If a doctor automictically assumes one is going to difficult or unwilling to be treated because of their race they may not to listen to what the patient is saying could treat a patient differently. In result the doctors or the nurse may not take the time that the patient needs. Health care providers are often booked back to back with multiple patients at the same time. a research study stated that “Healthcare professionals should pay special attention to the stimulation of accurate, frequent, and problem-solving communication with less educated patients based on shared goals and mutual respect” (Cramm & Neiboer). Spending more time with their patients allows not only the patient to ensure that they are getting the proper care that they need but the doctor and the nurse are ensuring that they are understanding the patient’s symptoms, signs and that they are giving the proper treatment.

References

• Cramm, J. M., & Nieboer, A. P. (2014, September 01). A longitudinal study to identify the influence of quality of chronic care delivery on productive interactions between patients and (teams of) healthcare professionals within disease management programmes. Retrieved from https://bmjopen.bmj.com/content/4/9/e005914
• Living with a chronic illness – reaching out to others: MedlinePlus Medical Encyclopedia. (2018). Retrieved from https://medlineplus.gov/ency/patientinstructions/000602.htm
• Oates, G. R., Jackson, B. E., Partridge, E. E., Singh, K. P., Fouad, M. N., & Bae, S. (2017, January). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5171223/
• Improving Chronic Illness Care. (2017). Care Coordination. Retrieved from http://www.improvingchroniccare.org/index.php?p=Background&s=350
• Partnership to Fight Chronic Disease. (2017). The Growing Crisis of Chronic Disease in the. Retrieved from http://www.fightchronicdisease.org/sites/default/files/docs/GrowingCrisisofChronicDiseaseintheUSfactsheet_81009.pdf
• US Census Bureau. (2019, April 16). Health Insurance Coverage in the United States: 2017. Retrieved from https://www.census.gov/library/publications/2018/demo/p60-264.html
• Thorpe, K. E., KO Chin, K., Cruz , Y., Innocent , M. A., & Singh , L. (2017, August 17). The United States Can Reduce Socioeconomic Disparities By Focusing On Chronic Diseases. Retrieved from https://www.healthaffairs.org/do/10.1377/hblog20170817.061561/full/
• About Chronic Conditions. (2016, April 18). Retrieved from http://www.nationalhealthcouncil.org/newsroom/about-chronic-conditions