Health system needs to focus on prevention

Canada’s health care system could be doing a better job of preventing, identifying and managing the growing prevalence of chronic diseases, according to a report from the Health Council of Canada.

The report titled, “Why Health Care Renewal Matters: Lessons from Diabetes,” used type 2 diabetes as a case study to look at whether the country’s health system is effectively helping Canadians manage chronic conditions.

It suggests that what is needed is a shift from a focus on finding disease and fixing it, to preventing chronic conditions, then ensuring that those diagnosed with the diseases know how to manage them.

The report says such a shift in focus would have a “profound, positive impact on the lives of Canadians,” while also helping ensure the sustainability of our health care.

Dr. Jeanne Besner, Chair of the Health Council of Canada, says the health system in Canada has always worked along a “find it and fix it” model. That worked fine when the biggest health threats in the country were infectious diseases, such as polio and life expectancy was low. But that model is now out of date.

“Because of advances in health care we are able to manage diseases more now than before, but the system is not designed to help manage those conditions,” she told Canada AM.

The report concludes that what is needed is a team of health care providers, such as public health nurses, nutritionists and pharmacists, working together with family physicians in their practices to better manage chronic conditions.

Besner says type 2 diabetes was chosen for the case study because it “is a good example of a disease that is, in large part, preventable if we identify people at risk early enough.”

“It is also a disease that, if not well-managed, can lead to a lot of complications. So it provides an opportunity to demonstrate that by doing things differently in the health care system … we’re able to prevent a lot of the complications that are now occurring,”

Type 2 diabetes affects at least 1.3 million Canadians, and hundreds of thousands more are unaware that they have the condition.

Three-quarters of those living with diabetes also have other chronic health conditions, the Health Council found. Many suffer the serious complications typical of diabetes, such as heart disease, kidney damage, depression, loss of vision, and poor circulation, which can lead to amputations.

But with the right kind of health care, these health problems — which reduce the quality of life for people with diabetes and drive up the cost of their health care — can be prevented, the report concludes.

The report says there is strong evidence that delivering care through teams made up of nurses, pharmacists, nutritionists and doctors helps patients improve their blood sugar levels. Yet, the report said “few Canadians have routine access to teams of health care professionals where they receive health care.”

Screening programs and community initiatives to help people better manage diet and lifestyle choices can have a major impact on preventing or delaying the onset of disease, but we need to take action now, to stem the rising tide of diabetes and related chronic health conditions, the report concludes.

“The lesson is clear. People with diabetes will need less intensive, less expensive, health care in the future, if they get the right care now.” said Dr. Stanley Vollant, a councillor with the Health Council of Canada.

The report concludes that the key to managing the burden of all chronic diseases is prevention.

“Promotion of healthy living to prevent chronic health conditions requires a strategic combination of public policy, targeted clinical care, and a range of community-based campaigns to motivate people to change their eating and exercise habits,” states the 70-page report.

“Canada faces an unprecedented need for public investments in prevention.”

Online consultation launches today

The Health Council of Canada wants to hear what Canadians affected by diabetes and other chronic health conditions have to say about health care. The Council invites all Canadians to visit their website and respond to a set of choices on health care priorities. As well, they can share their personal stories.

“By hearing directly from Canadians about their experiences and priorities, we hope to gain and share a broader understanding of what they say is working and what needs to change in our health care system,” said Besner said in a news release.

Canadians can offer their ideas and comments by visiting the Health Council of Canada website, until April 15, 2007.

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