Alberta Health Services, Calgary, Alberta, Canada.
Alberta Health Services, Calgary, Alberta, Canada.
Can J Diabetes. 2013 Aug;37(4):254-259. doi: 10.1016/j.jcjd.2013.04.001. Epub 2013 Aug 2.
The most common presentation of chronic disease is multimorbidity. Disease management strategies are similar across most chronic diseases. Given the prevalence of multimorbidity and the commonality in approaches, fragmented single disease management must be replaced with integrated care of the whole person. The Alberta Healthy Living Program, a community-based chronic disease management program, supports adults with, or at risk for, chronic disease to improve their health and well being. Participants gain confidence and skills in how to manage their chronic disease(s) by learning to understand their health condition, make healthy eating choices, exercise safely and cope emotionally. The program includes 3 service pillars: disease-specific and general health patient education, disease-spanning supervised exercise and Better Choices, Better Health(TM) self-management workshops. Services are delivered in the community by an interprofessional team and can be tailored to target specific diverse and vulnerable populations, such as Aboriginal, ethno-cultural and francophone groups and those experiencing homelessness. Programs may be offered as a partnership between Alberta Health Services, primary care and community organizations. Common standards reduce provincial variation in care, yet maintain sufficient flexibility to meet local and diverse needs and achieve equity in care. The model has been implemented successfully in 108 communities across Alberta. This approach is associated with reduced acute care utilization and improved clinical indicators, and achieves efficiencies through an integrated, disease-spanning patient-centred approach.
慢性病最常见的表现形式是多种疾病并存。大多数慢性病的疾病管理策略相似。鉴于多种疾病的普遍存在和方法的共性,必须用整个人的综合护理来替代分散的单一疾病管理。阿尔伯塔省健康生活计划是一个基于社区的慢性病管理计划,旨在帮助患有慢性病或有患病风险的成年人改善他们的健康和幸福感。通过学习了解自己的健康状况、做出健康的饮食选择、安全锻炼和情绪应对,参与者获得了管理自己的慢性疾病的信心和技能。该计划包括 3 个服务支柱:针对特定疾病和一般健康的患者教育、跨疾病监督锻炼和 Better Choices, Better Health(TM)自我管理研讨会。服务由跨专业团队在社区提供,并可根据目标特定的多样化和弱势群体进行定制,如原住民、族裔文化和法语群体以及无家可归者。该计划可以作为艾伯塔省卫生服务、初级保健和社区组织之间的合作关系提供。共同的标准减少了护理方面的省级差异,但仍保持足够的灵活性,以满足当地和多样化的需求,并实现护理公平。该模式已在艾伯塔省的 108 个社区成功实施。这种方法与减少急性护理利用和改善临床指标有关,并通过综合、跨疾病的以患者为中心的方法实现效率。