Prevention across the Continuum Essay

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Introduction

Chronic diseases are defined as diseases that are persistent, mostly incurable and often characterized with the complicated casualty, a wide range of risks, prolonged latency and illness period and can lead to impairment of body organs or cause disability (Australian National Health Priority Council, 2005). Chronic diseases have a great impact on the Australian economy in that the Australian government committed money equivalent to US$35 billion in the period between 2000-2001, which is close to two-thirds of the total expenditure on health care, to address the treatment, management and control of the various chronic diseases (Australian Institute of Health and Welfare, 2002). This resulted in the endorsement of a national-strategic policy by the Australian government, an approach that was formulated in order to improve and manage the prevention of chronic diseases in Australia. This strategic policy developed three elements for the management and prevention of chronic diseases; of these three elements was the national chronic disease strategy.

Definition of the action area

The impact of chronic diseases is highly manifested in Australia; seventy percent of the total deaths diminished healthy life expectancy and disability reported in Australia results from these chronic diseases. This is likely to rise to eighty percent by the year (2007) (Australian Institute of Health and Welfare, 2004). The said diseases affect individuals whose ages range from twenty-four to sixty-five years old. According to the National Public Health Partnership (2001), “the indigenous communities in Australia are the most highly affected by chronic diseases”. These chronic diseases do not stop a patient’s life instantly; however, they have an extensive range of negative effects on the patient’s quality of life, health, and economic position as well as the well-being of the families and the communities, because such members waste many hours in taking care of the sick (Catford, 2007). The World Health Organization (WHO) in its 2005 study estimated that due to the increasing rates of the impacts associated with chronic diseases, close to 75 percent of the global deaths will result from these diseases. According to Mathers, Voc and Stevenson (1999), “chronic diseases are attacking around 100 million people in the United States; therefore, more than $650 billion is estimated to be spent on managing chronic diseases each year”.

According to the World Health Organization (2005), the death caused by infectious diseases, prenatal and maternal conditions and nutrition deficiency diseases all combined is expected to decrease at a rate of 3 percent, while the deaths caused by chronic diseases are expected to increase by a rate of 17 percent during the same period of time. Chang and Johnson (2008) also asserted that “chronic diseases develop at a slow pace but are the leading cause of health complications which results in a bad quality of life and even premature births”. These diseases also cause socio-economic problems, because a lot of resources are required in the prevention of the diseases. For instance, China has allocated US$558 billion for the next ten years to cater for premature births that result from diabetes, heart disease and stroke (Wang, et al., 2005). A similar situation exists in Australia where the cost of treating a patient with diabetes is twice the cost of treating one who does not have the same condition, implying that three billion US dollars per annum are required to treat diabetes (Kernick, 2002).

The Australian National Health Priority Action Council (2006) informed that “the national chronic disease strategy focused on the five major chronic diseases which included diabetes, asthma, cancer musculoskeletal and cardiovascular diseases”. These diseases were selected because they are the major causes of disability for the people of Australia. The management of these chronic diseases requires close attention to the patient, with the patient also expected to play a major role (Lorig, et al., 1996). This paper will therefore critically examine early detection and early treatment of chronic diseases by using the Australian Government’s 2005 National Chronic Disease Strategy (NCDS). The paper will analyze the various services provided by the health sectors in order to ensure that diseases are detected and treated early. Lastly, the paper will evaluate the success of this method in the fight against chronic diseases.

National Chronic Disease Strategy (NCDS)

Patients with chronic diseases are aware of the kind of healthcare system that they need in order to live a healthy life. Kernick (17) argued that:

“patients with chronic medical conditions need access to high-quality information about their condition, care which is continuous and well-coordinated, effective management of their symptoms and — perhaps most importantly — help in managing the social, economic and psychological consequences of their symptoms.”

The National Chronic Disease Strategy is an ambitious and well-timed strategy that, if implemented well, can help in the fight against chronic diseases. In order to implement this strategy, the policymakers should implement all the changes in the political and economic scenarios that are required to make the healthcare system of Australia work fruitfully (Kernick, 2002). There is a need to mobilize the available resources and put the right structures in place for the achievement of the aim to detect and treat chronic diseases at an early stage.

The target group of the program

The early detection and cure of chronic diseases are very important in primary health care. An update of the patients with chronic disease should be well stored in an electronic system to ensure the recalling of patient records is easy. The Australian government has a health connect program that assists the providers of health care to communicate with all other stakeholders in the health sector in order to share information about patients with chronic diseases (Ford, Nassar & Sullivan, 2003).

Aims and objectives of the program

The National Chronic Disease Strategy focuses on introducing an education program that educates the health professionals, the patients and the general public on matters concerning chronic diseases. Education on topics related to chronic disease is important so that everyone can easily recognize chronic diseases at an early stage. Moreover, by knowing the dangers associated with these chronic diseases, one can take the initiative to treat the disease without delay. Education should be made available to everyone via the media or any other public education means so that everyone is able to detect a chronic disease early. In addition to such detection, the education program should enable patients to self-manage their disease and seek the immediate attention of a health professional (Baker, et al., 2004).

In the Australian NCDS that was passed by the Advisory Council of the Australian Health Minister, the core objective is chronic diseases prevention and ensuring that there is quality health care for the people of Australia. Early detection and treatment of chronic disease is a framework developed within this strategy adopted between the years 2000 and 2001. The policy guide of this strategy provides education to all the key players in the health sector to be in a position to have early detection of disease symptoms, provide a cure for the disease, minimize all health risks and provide continuous care for the patient (Chang & Johnson, 2008).

The core aims of the National Chronic Disease Strategy (NCDS) are to minimize all forms of complication associated with the chronic disease, improve the quality of life of the patient and their family, minimize government expenditure on health care by reducing the number of patients being admitted to the hospitals and cut the costs of health care, and lastly improve the capacity of the health professionals to be in a position to deliver quality medical care as per the demands of the citizens (National Chronic Disease Strategy, 2005). (Magnus & Sadkowsky, 2006).

Early detection of a disease is vital in that one can easily change the lifestyle that causes the disease or take medication at an early stage. This is considerably important in that most chronic diseases develop at an early stage, even in childhood; therefore, a child can be treated or preventative measures of a disease can be introduced at an early stage. Moreover, according to Catford (2007), as a child grows, they should be healthy so as to be able to contribute to the economic development of a country.

Outcomes of the program

The National Chronic Disease Strategy (2005) in Australia focused on an education program that will create knowledge for the stakeholders in the healthcare sector (Lorig, et al., 1996). Since the introduction of the strategy, healthcare facilities have been equipped with enough knowledge to undertake early diagnosis and treatment of chronic diseases. Such early detection of chronic disease by a patient or the community is important since the case may be reported to the healthcare professionals at an early stage (Ford, 2003). The Australian government uses a model of information flow that enables the key players in the healthcare sector to exchange information with other stakeholders on the status of the disease. Information sharing is important in that measures to care for a disease are taken promptly and the resources which are needed can be easily accessed from any of the identified sources (Baker, et al., 2004).

A country that has a high number of people with chronic disease is more likely to feel the economic effects of the health care for this than a country with fewer cases of chronic disease. Furthermore, the cost of health care for the people affected by the chronic disease is high (Baker, et al., 2004). Hence, the National Chronic Disease Strategy intends to cut down the cost of healthcare for patients suffering from chronic disease. This could be achieved by detecting and treating the disease at an early age, which is effective since the disease will not be fully developed and therefore treating the disease at this stage will be easier and less expensive.

Early detection and treatment of chronic disease involve the sufferers of the disease making informed decisions, developing a positive attitude and developing the willingness to cooperate with the medical professionals in the identification of a problem at an early stage (Lorig, et al., 1999). The patient has a major role to play because their willingness and change in attitude is considered to lead to the success in preventing chronic disease in Australia (NCDS, 2005). Moreover, society should play a major role in the identification of chronic disease, which can only be possible with good communication channels that help people gain knowledge of the presence of chronic disease. Through this effective communication network, the society can deliver such information on the disease to the healthcare professionals or any other responsible stakeholder in the health sector (Kernick, 2002).

The National Chronic Disease Strategy (2005) stressed the importance of education as a way of making people know what chronic diseases are as well as their symptoms and signs, their effects and solutions to the problems they cause. (Ford, et al.,2003). The use of education also helps to create partnerships in finding the solutions to the problems caused by chronic diseases. These partnerships help in decision making, problem-solving, and resource use planning for the management of chronic diseases (Joanne & Richard, 2007).

The success of the program in relation to the NCDS

The early detection and treatment of chronic diseases made possible by the adoption of the National Chronic Disease Strategy have been a success. A study that was done to assess the results of early detection and treatment of fifty-four diabetes and obesity patients found that the NCDS framework is effective (Chodosh et al., 2005). Through awareness, patients with diabetes and obesity just need to know their levels of glucose and fats respectively so as to detect the dangers and take early curative measures (Chodosh et al., 2005).

Comparison of the program with similar international programs

The National Chronic Disease Strategy (NCDS) is one of the most influential and successful programs in Australia and in fact other developed and developing countries have adopted the strategy. This program for example has enabled Australia to have one of the lowest numbers of chronic patients after countries like China, Japan and other countries which provide their citizens with knowledge on early detection of chronic diseases. This program has to lead to success in Australia in the fight against chronic diseases. National Chronic Disease Strategy works the same way as international programs like Millennium Promise Awards: Non-communicable Chronic Research Program whose mission is to strengthen research on chronic diseases in low-income countries. This program builds capacity on diseases such as lung cancer, cerebrovascular diseases and obesity. Other than capacity building in research members of the staff in this program educates the public on the symptoms of these diseases and stress the importance of early treatment.

Another similar program is the International Congress on Chronic Disease Self-Management. The mission of this program is to educate people on primary health care for chronic diseases and enhance health literacy. This program’s objectives are therefore to enable members of the public and the health professionals to detect chronic diseases at an early stage.

Conclusion and Recommendations

Chronic diseases in Australia have a great impact on the economy, the community, families and individuals. In order to reduce these impacts, the Australian government has adopted the National Chronic Disease Strategy (NCDS) that aims at providing preventative measures to reduce or even eradicate these diseases. Early detection and early treatment measures discussed above are preventative measures adopted by the Australian government. Through mass media, public education and the internet, people are educated about these chronic diseases and about ways of preventing them. This is an effective method for the prevention of the increase in cases of chronic diseases. The abovementioned policy has helped the Australian government be able to reduce the number of people suffering from chronic diseases (National Chronic Disease Strategy, 2004).

According to Rothman (2000), there is a need for annual checkups in order to detect the presence or the likelihood of chronic disease. Rothman (2000) recommends such annual check-ups for diseases like diabetes and obesity whereby cholesterol levels, blood sugar and body mass index (IBM) are tested for patients above thirty years of age. Detection of diabetes and obesity should also be done in children who can be prone to these diseases. This category of children includes the children whose family history has records of people suffering from chronic diseases (Mansfield, 2003). The objectives of these tests are to identify people before they become victims of chronic disease. Once they are tested, either a cure can be found at this early stage or preventative measures can be introduced so as to be safe from being a victim. A further recommendation is provided by Mansfield (2003) where “a funding mechanism (for example medical schemes item numbers) should be implemented for patients annual check-ups and for their certified weight loss and weight management programs”. Such programs should have a general management practice and should be done by a nurse or any other qualified healthcare professional by following the general practice of a patient. The general practice is meant to detect health conditions like pre-diabetes; rising cholesterol levels and the presence of any cardiovascular disease before such diseases develop critical health problems. The early detection enables a patient to adopt nutritional behaviors and a lifestyle that is healthier and would prevent the occurrence of symptoms that call for higher medical attention and expensive treatment. Through the use of information technology, patients can easily access safe lifestyle programs via the internet (McCormack & Garbett, 2007).

Another method to ensure that there is early detection for chronic disease is through public awareness campaigns (Farrell, Wicks & Martin, 2004). The National Chronic Disease Strategy through its education campaign organizes several campaigns (social networking) to create public awareness. The objectives of these campaigns are to ensure that people learn about the preventative measures for the various chronic diseases and are able to detect the presence of these chronic diseases once they know about the symptoms. For example, the “2 and 5 campaign” promotes people to eat more vegetables and fruit, and the “get moving” campaign encourages children to do more physical activities. The success of some campaigns such as HIV/AIDS transmission and the reduction of smoking in Australia have had positive results in the reduction of chronic disease. This can be attributed to coordinated public awareness nationally and the use of mass media (Jones, Pill & Adams, 2000).

References

Baker, D. et al, (2004). Review of proposed National Health Priority Area asthma indicators and data sources. Canberra: Australian Institute of Health and Welfare

Catford, J. (2007). Chronic disease: preventing the world’s next tidal wave-the challenge for Canada. Health Promotion International, 22(1), 1-4.

Chang, E. & Johnson, A. (2008). Chronic Illness and Disabilities. Sydney: Churchill Livingstone.

Chodosh, J. et al. (2005). Meta-analysis: chronic disease self-management programs for older adults. Annals of Internal Medicine, 143(6) 427-438.

Farrell, K., Wicks, M., & Martin, J. (2004). Chronic Disease Self Management Improved with Enhanced Self-Efficacy. Clinical Nursing Research, 289-308.

Ford, J., et al. (2003). Reproductive health indicators Australia. Sydney: Sage Publications.

Joanne, E., J., & Richard, H. O. (2007). Chronic disease self-management education programs: challenges ahead. The Medical Journal of Australia, 186(2), 84–87

Jones, A., Pill, R., & Adams, S. (2000) Qualitative study of views of health professionals and patients on guided self-management plans for asthma. British Medical Journal, 321(7275), 1507-1510.

Kernick D. (2002) Complexity and health care organization: a view from the street. Abingdon: Radcliffe Press.

Lorig, K.R., Stewart, A., Ritter, P.L., & González, V. (1996). Outcome Measures for Health Education and other Health Care Interventions. Thousand Oaks: Sage Publications.

Magnus, P & Sadkowsky, K (2006). Mortality over the twentieth century in Australia. Canberra: Australian Institute of Health and Welfare.

Mansfield, A. (2003) Sustaining a ‘secondary disease prevention’ approach to chronic disease management: a chronically complex issue. Australian Journal of Primary Health, 9(2&3), 155-159.

Mathers, C., Voc, T., and Stevenson, C. (1999). The burden of disease and injury in Australia. Canberra: Australian Institute of Health and Welfare.

Rothman, A. (2000). Toward a theory-based analysis of behavioral maintenance. Health Psychology, 19(1 (supplement1)), 64-69.

Wang, L. et al, (2005). Preventing chronic diseases in China. Lancet 366:1821–1824 oxford university press.

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