Physician's Capitation Trends-Heart disease ravages health and resources
Why you should focus on CHD
Coronary heart disease (CHD) is America's biggest and costliest health predator. Its devastation to life and health could be drastically reduced, however, by changes at two levels:
1. Patient behavior changes — quitting tobacco use, increasing exercise, and improving diet.
2. Clinical behavior changes — identifying high-risk patients; following "best practices," or clinical guidelines; and adhering to established drug prescriptions that avoid contraindications, according to William J. Waugh, PharmD, director of disease state management and outcomes research at Wellpoint Pharmacy Management, a part of Wellpoint HMO based in Calabasas Hills, CA.
If your practice is considering a Medicare risk contract, key epidemiological and economic trends are important to apply when looking at the patient base and how your practice already manages CHF patients. The Atlanta-based Centers for Disease Control and Prevention (CDC) reports these current trends in coronary heart disease (CHD):
• CHD is the single largest killer of American males and females.
• About every 29 seconds an American will suffer a coronary event, and about every minute someone will die from one.
• This year, an estimated 1.1 million Ameri-cans will have a new or recurrent coronary attack — defined as myocardial infarction (MI) or fatal CHD. About 650,000 of these will be first attacks, and 450,000 will be recurrent attacks.
• More than 40% of those who experience a heart attack in a given year will die from it.
• About 225,000 people a year die of CHD without being hospitalized. Many of these are sudden deaths caused by cardiac arrest, usually resulting from ventricular fibrillation.
• 12.2 million people alive today have a history of heart attack, angina pectoris (chest pain), or both. This breaks down to 5.9 million men and 6.2 million women.
• It's estimated that 7.2 million Americans, 20 and older, have a history of MI (4.4 million men and 2.8 million women).
• From 1987 to 1997, the death rate from CHD declined 24.9%, but the actual number of deaths declined only 9%.
(CDC information is based on data from the "Atherosclerosis Risk in Communities" study of the National Heart, Lung, and Blood Institute, 1987-1994." These data represent Americans hospitalized with definite or probable MI or fatal CHD, not including silent MIs.)
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