Managing Care for Adults with Chronic Conditions

Why This Focus?

Chronic conditions are the leading cause of death and disability in the U.S., and more than 45 percent of the population (125 million Americans) have one or more chronic conditions. Health care spending for people with chronic conditions accounts for 78 percent of all health care spending, and the number of people with these conditions is rapidly increasing. Between 2000 and 2030, the number of Americans with chronic conditions is expected to increase by 37 percent (46 million people).

A snapshot of those with chronic conditions reveals that:

• Chronic conditions affect women disproportionately (80 percent of women aged 65 to 85 report at least one chronic condition compared to 33 percent of men in that age group).
• Half of all people with chronic conditions have multiple chronic conditions.
• Among people over 65, hypertension is the most common chronic condition.
• Among those 18 to 64, chronic mental conditions are the most common.

People with chronic conditions are the heaviest users of medical care, accounting for 96 percent of home health visits, 88 percent of prescription drugs, 76 percent of in-patient stays, and 72 percent of physician visits. More than half of people with serious chronic conditions see three or more physicians, and 81 percent of people with serious chronic conditions see two or more.

A 2002 Gallup survey of people with chronic conditions found that these patients often received conflicting advice, were sent for duplicate tests or procedures, were diagnosed with a different problem, and/or were not told of a potential prescription drug interaction.

Evidence suggests that the cost of caring for persons with one or more chronic conditions may be minimized and the quality of their lives improved if preventive measures are implemented early and more attention is given to coordinating care and services. Strategies to prevent and manage chronic conditions range from prevention and education to extensive interventions that cross disciplines and delivery systems.

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