Diabetes Care in the Capital Health Region: A Model of Chronic Disease Management

Abstract

The prevalence of chronic disease is increasing in Canada and around the world. People are living longer and are developing chronic conditions and often multiple co-morbidities. The growing population of people suffering from chronic disease is straining health care systems and challenging health providers to rethink the system of care for disease management. The old system of care failed to meet many of the needs of chronic care patients due to gaps in care, inconsistencies, and lack of evidence-based practice standards. A new paradigm of chronic disease management is the Chronic Care Model developed by Wagner (2004) and his associates. This model emphasizes patient-centered-care that is evidence-based and systematic. The Capital Health Region in Alberta has adopted the elements of Wagner’s model to create an integrated chronic disease care model to address the challenges of chronic disease management in the region. This new process approach has enhanced the responsiveness of the region’s diabetes services by increasing access to diabetes services while at the same time decreasing wait times.