Health Surveillance and Disease Prevention and Control / Chronic Diseases
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Integrated Management of Chronic Diseases and Risk Factors | Documentation & LinksObjective: To facilitate and support the strengthening of the capacity and competencies of the health system for the integrated management of chronic diseases and their risk factors. The current acute health care model has not proven effective in dealing with prevention and management of chronic conditions. Successful chronic disease programs require an intersectoral approach and a reorientation of the healthcare system. It is necessary to improve the accessibility and availability of services and access to essential medicines and to have multidisciplinary health teams with the appropriate skill mix delivering services. Emphasis is needed on quality of care to reduce barriers related to social, economic, and cultural factors and to improve social protection for health, particularly among vulnerable populations. In order to face these challenges, PAHO's action plan considers that prevention and management of chronic diseases requires integration through strengthened referrals and relationships among primary, secondary, and tertiary levels of care. The entire spectrum of disease management from prevention to screening and early detection, diagnosis, treatment, rehabilitation, and palliative care is necessary. The constructs of the Chronic Care Model1 are incorporated into the objective for the management of chronic diseases and risk factors, and are aimed at improving outcomes in five areas:
These areas are as follows:
This plan also considers technical assistance for chronic disease programs, the reorientation of health services towards chronic diseases, and improved access to essential medicines and technologies. PAHO's strategy recognizes the call for a renewed approach to primary health care and the highest attainable level of health for everyone as emphasized in the Regional Declaration on the New Orientations for Primary Health Care (promulgated at the 46th Directing Council). Also reflected in this plan is Resolution CD45.R7: Access to Medicines, which prioritizes access to medicine and other health supplies. Documentation & LinksCaribbean Chronic Care Collaborative / Caribbean Diabetes Project (CCCC/CARIDIAB) | espaņol: Documentation listed below:
Questionnaire to Assess the Diagnosis & Treatment of Chronic Diseases By topic
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Full project description, 15 pp1 Wagner EH, Glasgow RE, Davis C, Bonomi AE, Provost L, McCulloch D, Carver P, Sixta C. Quality Improvement in Cronic Illness Care. A Collaborative Approach. J Quality Improvement 2001;27(2):63-80.