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1、TheMichiganPrimaryCareConsortiumEpiDivisionDayCarolCallaghanNovember10,2010W.H.O.onAcutevs.ChronicCare“Healthcaresystems[throughouttheworld]evolvedaroundtheconceptofinfectiousdisease,andtheyperformbestwhenaddressingpatients’episodicandurgentconcerns.However,theacutecar
2、eparadigmisnolongeradequateforthechanginghealthproblemsintoday’sworld.Bothhigh-andlow-incomecountriesspendbillionsofdollarsonunnecessaryhospitaladmissions,expensivetechnologies,andcollectionofuselessclinicalinformation.Aslongastheacutecaremodeldominateshealthcaresystem
3、s,healthcareexpenditureswillcontinuetoescalate,butimprovementsinthepopulation’shealthstatuswillnot.”WorldHealthOrganization.Innovativecareforchronicconditions:buildingblocksforaction:globalreport.(Geneva:WHO;2002.)HealthCareSpendingIn2007,theU.S.spent$2.2trillion—ormor
4、ethan16%ofitsGrossDomesticProduct—onhealthcare.Wespendmorethananyothercountry,yetourhealthsystemcontinuallyunderperformsandlagsbehindlessadvancedcountries.3Copyright©2008byProjectHOPE,allrightsreserved.EllenNolteandC.MartinMcKee,MeasuringTheHealthOfNations:UpdatingAnEa
5、rlierAnalysis,HealthAffairs,Vol27,Issue1,58-71Copyright©2008byProjectHOPE,allrightsreserved.EllenNolteandC.MartinMcKee,MeasuringTheHealthOfNations:UpdatingAnEarlierAnalysis,HealthAffairs,Vol27,Issue1,58-716BrokenUSHealthCareSystemEver-risingcostsofhealthcareRisingrates
6、ofuninsured,underinsuredFlatorworseninghealthstatusindicatorsSignificanthealthdisparitiesUnimpressivequalityindicatorsRisingdissatisfactionbynearlyeveryoneAgingpopulationmeansgreaterdemandsonhealthcaresystem7PrimaryCareSysteminCrisisFragmented,uncoordinatedpatientcareI
7、nconsistentdeliveryofevidence-basedcare,especiallypreventiveandchroniccareMisalignedreimbursementsystem(volume,notvalue)Increasingexpectationsbypayersandpurchasersimpactingproviders’qualityoflifeShrinkingprimarycareworkforce(i.e.,physicians,NP’s,PA’s,others)Willprimary
8、caresurvive?8PrimaryCareMUSTbetheFoundationoftheU.S.HealthCareSystemMorePrimaryCarePhysiciansper100,000populationLowe
