The Chronic Care Model: Blueprint for Improving Total Diabetes Care

Chronic disease is a national epidemic. Over 100 million Americans, including nearly 80% of seniors, suffer illness, disability, and death related to chronic illnesses. One in five seniors has five or more chronic conditions, visits on average 14 different physicians, and uses an average of 50 different prescription medications per year. Two-thirds of Medicare funds are used to care for the 20% of seniors with five or more chronic illnesses, while the proportion of Americans with one or more chronic conditions is growing steadily. Diabetes, through its myriad complications, accounts for upwards of 20% of America’s chronic illness burden. Diabetes-associated heart disease, stroke, high blood pressure, blindness, kidney disease, amputations, nervous system disease, obesity, and dental disease can be prevented or lessened by proactive chronic-illness care, yet less than half of those diagnosed with diabetes receive care that is consistent with guidelines (Bodenheimer et al., 2002; Casalino et al., 2003; Hoffman et al., 1996; Murcko, 2004, March/April; National Center for Health Statistics, 2003).