Column: Chronic Disease Burden
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Today most health care discussions focus on health care reform with an emphasis on financing and access. Few will disagree, though, that healthcare costs in the United States are an increasingly costly burden. A key contributing factor to those rising costs is often ignored in reform discussions: the impact of chronic diseases.
In 2010, 75% of US healthcare spending was for the direct care of chronic diseases like heart disease, cancer, diabetes and pulmonary diseases like COPD and asthma. Although some of the risk factors for chronic diseases, like aging and genetics, cannot be changed or modified, others, like smoking and obesity, can be modified. Americans are able to reduce our overall healthcare costs by reducing these risk factors. For example, studies indicate that a 5% decrease in obesity rates could result in savings over $29 billion. While the ultimate responsibility for the diagnosis, treatment, and prevention of disease lies with the patient and his or her doctor, there are several third party and public health organizations providing valuable support to these efforts. It is expected that the 2018 budget for one of the key third parties, the Department for Health and Human Services, will be significantly reduced.
This article further explores the impact of chronic diseases on the healthcare landscape in the United States, discussing the key modifiable risk factors and opportunities for prevention and improved care management.
The Cost and Prevalence of Chronic Diseases
Half of all Americans have at least one chronic disease, like diabetes, cancer and heart disease, and almost a third have more than one condition. For adults, the most prevalent condition is heart disease. For children, the most common conditions are asthma and allergies.
The average healthcare cost per person varies by the number of chronic conditions the person has, as shown below in Table 1 below. The average cost for a person with just one chronic condition is over twice as high as person with no chronic conditions, and the average cost for a person with 5 or more conditions is over 13 times as high.
People with 5 or more conditions account for less than 9% of the population, but nearly 35% of total
The burden of chronic diseases goes far beyond the direct amounts spent on these diseases. In the U.S., 7 out of every 10 deaths are caused by chronic diseases each year.7 Additionally, there are indirect
costs through lost productivity and unmeasurable losses in the quality of life and the ability to perform activities of daily living like bathing and eating.
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