|
 In
the past century, advances in medicine led to longer life
spans for most Americans. As the number of aging Americans
increases, however, so does the number of Americans who live
with one or more chronic conditions such as diabetes, heart
disease, depression, arthritis, hypertension or osteoporosis.
Recent research shows that almost half (45 percent) of all
Americans have a chronic condition. The costs both to individuals
and to the health care system are enormous. In 2000, care
of chronic illness consumed 75 cents of every health care
dollar spent in the United States.
The systems of financing and delivering medical care in this
country have not yet adjusted to the complexities of caring
for individuals with chronic conditions. A recent Foundation-sponsored
study by researchers at the University of California, Berkeley,
and the University of Chicago found that tens of millions
of patients with chronic diseases are not receiving the type
of integrated care proven to be most effective in managing
the effects of their diseases.
Research also illustrates that the quality of health services
is often substandard, even though medical practitioners are
learning how to implement cost-effective, high-quality care
for many of the more problematic conditions. A report issued
in 2000 by the Institute of Medicine, To Err Is Human:
Building a Safer Health System, dramatically demonstrates
that as many as 98,000 hospitalized Americans die every year
and 1 million more are injured as a result of preventable
medical errors.
Quality of health care continues to be an issue at the end
of life. Health care professionals often lack the knowledge,
training and systems to enable individuals to die with dignity
and support and without pain. As a result, many patients with
terminal illnesses suffer needlessly in the final stages of
their lives.
Finally, the nation is grappling with serious shortages in
the health care workforce that are predicted to worsen. The
pool of nurses and other professional caregivers—such
as home health aides and personal attendants—is shrinking
faster than the pool of individuals who are training for and
staying in these jobs. And these problems are in part caused
by low job satisfaction and lack of training and support for
people in these positions.
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