This podcast is an interview with Dr. Anand Parekh, U.S. Department of Health and Human Services Deputy Assistant Secretary for Health, and Dr. Samuel Posner, Preventing Chronic Disease Editor in Chief, about the definition and burden of multiple chronic conditions in the United States. Created: 5/20/2013 by Preventing Chronic Disease (PCD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).
Date Released: 5/20/2013. Series Name: Preventing Chronic Disease.
[Announcer] This program is presented by the Centers for Disease Control and Prevention.
[Melissa Wilson] A growing population, age distribution, and disease dynamics forecast increases in the occurrence of chronic diseases and combinations of chronic conditions. I’m Melissa Wilson for CDC’s journal, Preventing Chronic Disease. Today, I’ll be talking with U.S. Department of Health and Human Services Deputy Assistant Secretary for Health Dr. Anand Parekh and Preventing Chronic Disease Editor in Chief Dr. Samuel Posner about the definition and burden of multiple chronic conditions in the U.S. population. Drs. Parekh and Posner are authors of an article entitled Defining and Measuring Chronic Conditions: Imperatives for Research, Policy, Program, and Practice, published in the April 25, 2013 issue of Preventing Chronic Disease. Their article is one of eight in a collection focusing on multiple chronic conditions. Thank you both for joining us today.
[Dr. Posner] Thank you for having us.
[Dr. Parekh] Good to be with you.
[Melissa Wilson] Dr. Posner, tell our listeners about your article and the collection.
[Dr. Posner] Sure. This collection presents the work of departmental-wide collaboration, bringing together multiple agencies to work on the topic of multiple chronic conditions using a common analytic framework. This collection examines the magnitude of the burden of multiple chronic conditions in the population. The first article, our article, outlines a framework for identifying common chronic conditions. The next five papers in the series describe the epidemiology of the list of the 20 chronic conditions in representative samples. These samples represent people living in the community, those seeking care in outpatient settings, those in inpatient settings, and Medicare beneficiaries. The seventh paper examines a subset of the chronic conditions that are amenable to intervention through behavioral interventions. And the final paper brings together the advances and challenges moving forward in this important field.
[Melissa Wilson] Dr. Parekh, what’s new to report in this collection and how can the results be used?
[Dr. Parekh] Thanks, Melissa. What’s new is that using multiple data sources, this collection expands knowledge about the high prevalence and health costs of multiple chronic conditions in the overall population and in subgroups, such as the Medicare population. It also provides new data on multiple chronic conditions amongst hospitalized patients and on the most common and costly combinations of chronic conditions. The results should help many key stakeholders, including health policy makers, health professionals, and public health agencies to better identify individuals vulnerable to poor outcomes and high costs associated with chronic conditions.
[Melissa Wilson] How does this fit into the larger efforts of the Department of Health and Human Services?
[Dr. Parekh] In December 2010, the U.S. Department of Health and Human Services launched The Strategic Framework on Multiple Chronic Conditions to help catalyze public and private sector actions to improve the quality of life and health status of individuals with multiple chronic conditions. This collection supports one of the key framework goals of supporting research to better understand the epidemiology and health care implications of multiple chronic conditions, so that actionable information can be learned to address this challenge.
[Melissa Wilson] Dr. Parekh, as a practicing physician, what are the challenges facing healthcare practitioners in this area?
[Dr. Parekh] Most health care practitioners have been taught to address one condition at a time, in spite of our population increasingly being found to have multiple conditions. This is further compounded by siloed funding streams and programs for individual conditions. With an increasing population with multiple chronic conditions, what practitioners need is improved information on how these conditions, or comorbidities, interact so they can take care of the patient holistically, in a patient-centered way.
[Melissa Wilson] Dr. Posner, what are the implications of this paper for public health research and programs?
[Dr. Posner] Our paper proposes a common framework that researchers in the field can use to bring consistency to their work. This consistency will help facilitate comparison of cross studies. Additionally, we expect that this paper will spur further refinement in measurement and reporting of multiple chronic conditions. The collection provides a foundation for further research in this area. It also serves as a touch point, bringing together research and practice in both public health and clinical settings.
[Melissa Wilson] Dr. Parekh, why address this topic now?
[Dr. Parekh] That’s a great question. We live in a time of a remarkable transformation in our health care system, particularly accelerated by the Affordable Care Act. Keeping the focus on people with multiple chronic conditions is vitally important if we’re to truly enhance health, improve care, and lower costs. How well we do in preventing and in managing multiple chronic conditions, I believe, will play a large role in determining the future health and prosperity of this country.
[Melissa Wilson] Thank you for joining us today, Dr. Parekh and Dr. Posner. You can read this article and the entire multiple chronic conditions collection at cdc.gov/pcd.
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