In November 1996, the Robert Wood Johnson Foundation released a chart book on chronic illness, noting that 99 million Americans endure the effects of one or more chronic conditions ranging from asthma to Alzheimer's. While the chart book includes a range of useful statistics describing chronically ill people, the publication also makes clear how much we do not know.
This chapter of the Anthology presents findings from the Foundation's attempt to learn more about chronically ill people and the service arrangements for them. The study focuses on a single community, Springfield, Mass. It broke important new ground in measuring unmet needs among chronically ill people and in documenting what happens when their needs for care go unmet. It is unique in that it surveys both people with chronic illnesses and service providers caring for these individuals. The study attempted to understand what the dimensions of a "chronic care system" are, as illustrated by one American community.
Why did the Foundation provide resources for such a study? It hoped that the findings would inform their efforts to make grants to improve the organization and delivery of services for people with chronic conditions, and would be useful for officials and service providers in Springfield and other cities. It also wanted to look at the value Americans place on support services for people with chronic conditions.
- 1. Foreword
- 2. Editors' Introduction
- 3. Acknowledgements: 1997
- 4. Reach Out
- 5. A Review of the National Access-to-Care Surveys
- 6. Improving the Health Care Workforce
- 7. Expertise Meets Politics
- 8. The Media and Change in Health Systems
- 9. Addressing the Problem of Medical Malpractice
- 10. Unmet Need in the Community
- 11. Unexpected Returns
- 12. Developing Child Immunizations Registries
- 13. The Homeless Families Program
- 14. The National Health and Social Life Survey