Theme 6
Lecture
The role of the community in promoting PCCD
Context: aging populations, increase of chronic diseases -> increasing multiple complex needs, limiting
health and social care costs (policy of aging in place (at home)). Older people spent 80% of their time at
home. They are more dependent on their community. CCM does not focus on strategies to prevent
disease. It is mainly focused on clinically oriented systems and outcomes. Difficult to use for prevention
and health promotion practitioners. Does not encompass the complexity and interplay of social, cultural
and economic factors that affect health. The capacity of communities in addressing these conditions.
Expanded Chronic Care Model
Health system is a part of the community.
> Self-management/develop personal skills: support of self-management in coping with disease. Also,
developing skills for health and well-being. Strategies in health system as well as community.
> Delivery system design: holistic way of providing support to individuals and communities. Connections
between health and broader social, political, economic and physical environmental conditions.
> Decision support: decision support is not only related to disease and treatment. Also, evidence on
strategies for well-being and health living. Community-based best practice. Schijf van 5. Valpreventie.
> Information systems: community data beyond the healthcare system. Support information about
demographics, population health and trends (cultural, social, economic). Municipalities.
> Build healthy public policy: policy and legislation aimed at improving population health. Safe and
healthier goods, services and environment. Reducing salts in food, making fruit cheaper.
> Create supportive environments: realizing living and employment conditions that are safe, stimulating,
satisfying and enjoyable.
> Strengthen community action: empowerment of communities. Partnering with communities to
promote community health and healthy environments.
Outcomes: productive
interactions and
relationships among
community
members/groups,
healthcare
professionals and
organizations.
Functional and clinical
outcomes as well as
population health
outcomes.
The innovative Care for Chronic Conditions (ICCC) framework
Primary care is oriented toward acute problems and urgent needs in developing countries. When health
problems are chronic, the acute are practice model doesn’t work. Solutions necessary to address
healthcare demands of chronic conditions in countries with limited or stressed primary care
infrastructure, like in many developing countries contexts.
Lecture
The role of the community in promoting PCCD
Context: aging populations, increase of chronic diseases -> increasing multiple complex needs, limiting
health and social care costs (policy of aging in place (at home)). Older people spent 80% of their time at
home. They are more dependent on their community. CCM does not focus on strategies to prevent
disease. It is mainly focused on clinically oriented systems and outcomes. Difficult to use for prevention
and health promotion practitioners. Does not encompass the complexity and interplay of social, cultural
and economic factors that affect health. The capacity of communities in addressing these conditions.
Expanded Chronic Care Model
Health system is a part of the community.
> Self-management/develop personal skills: support of self-management in coping with disease. Also,
developing skills for health and well-being. Strategies in health system as well as community.
> Delivery system design: holistic way of providing support to individuals and communities. Connections
between health and broader social, political, economic and physical environmental conditions.
> Decision support: decision support is not only related to disease and treatment. Also, evidence on
strategies for well-being and health living. Community-based best practice. Schijf van 5. Valpreventie.
> Information systems: community data beyond the healthcare system. Support information about
demographics, population health and trends (cultural, social, economic). Municipalities.
> Build healthy public policy: policy and legislation aimed at improving population health. Safe and
healthier goods, services and environment. Reducing salts in food, making fruit cheaper.
> Create supportive environments: realizing living and employment conditions that are safe, stimulating,
satisfying and enjoyable.
> Strengthen community action: empowerment of communities. Partnering with communities to
promote community health and healthy environments.
Outcomes: productive
interactions and
relationships among
community
members/groups,
healthcare
professionals and
organizations.
Functional and clinical
outcomes as well as
population health
outcomes.
The innovative Care for Chronic Conditions (ICCC) framework
Primary care is oriented toward acute problems and urgent needs in developing countries. When health
problems are chronic, the acute are practice model doesn’t work. Solutions necessary to address
healthcare demands of chronic conditions in countries with limited or stressed primary care
infrastructure, like in many developing countries contexts.
