Improving chronic illness care : the chronic care model

Abstract

More than 100,000 Maltese, almost 25 per cent of the population (N50 Census, 2005) live with a chronic condition and many have multiple conditions (H.l.5. Malta, 2003). Chronic illness has been defined as a long- term or permanent illness that often results in some type of disability and which may require a person to seek help with various activities Wagner (1998). Very broadly this includes any condition that requires ongoing activities in response to patients and their personal needs and in response of their health care givers as well as in response of the medical care system. 50 this includes the more traditional conditions such as physical chronic illness like diabetes, hypertenson and heart disease but it also includes chronic mental disorders, like major depression, it includes behavioural disorders like attention deficit disorders in children, some applying this to things like addiction, or harmful behaviours like cigarette smoking. Research abroad (Wagner et al. , 2004) shows that not only a large percent of the population have a chronic condition but these people tend to have more than one chronic condition sometimes two, three, four or even more. It is these persons with multiple chronic conditions that consume that most amount of the health care budget money which includes both community care and hospital care. 50 this substanial group of the total population is very important both from the economical aspect and from the clinical aspect. To properly meet the health care needs of these persons we cannot speak any longer about disease management but about patient-centred care.