Examining Chronic Care in California's Safety Net

Publication Date: July 2003

Publisher: California HealthCare Foundation

Author(s): Thomas Bodenheimer

Research Area: Health

Type: Report

Coverage: California

Abstract:

One hundred million people in the United States have at least one chronic condition. Chronic illness accounts for three-quarters of total national health care expenditures. However, care for chronic conditions is seriously inadequate. On average, 72% of persistent asthmatics cared for in California physician groups do not use steroid inhalers, which is the indicated medication. Other chronic illnesses are similarly poorly controlled. Many chronic conditions have an increased prevalence among the populations who use the health care safety net; yet, these people have the most difficulty accessing health care. This July 2003 report examines the delivery of chronic care in California's health care safety net--insitutions that deliver a significant amount of health care to the uninsured, Medicaid beneficiaries, and other vulnerable patients--and focuses on county health systems and community clinics. The research sought out programs targeting asthma in children, congestive heart failure (CHF), diabetes, and hypertension; few programs were found for CHF and hypertension.