Effects of Chronic Medical Conditions on Health Care Service Provision - Essay Example

? Chronic Health Conditions Effects of chronic medical conditions on health care service provision According to Hill and Philips (2006, pg.107), balancing the needs of people requiring acute medical care for chronic medical conditions with long-term progressive disabling conditions poses a significant challenge for health care services nearly in all developed nations. Chronic diseases account for nearly 35 million people worldwide. This number has mainly been aggravated by a number of reasons that have consequently affected the provision of health care services, especially in pre-hospital settings. To begin with, the World health Organization (WHO) presents that chronic health conditions have become rather difficult to handle due to a wide societal perception that low and middle income earners within the society tend to lay more emphasis on controlling infectious diseases prior to tackling chronic diseases (Dalal et.al 2011, pg. 1516). Subsequently, Goldberg et.al (2012, pg. 234) explains that most patients with chronic conditions tend to seek medical attention at advanced stages. This usually calls for modernized and high costing equipment necessary for resuscitation processes in the event of any complication. Diabetes and Cardiovascular disease interactivity Ganda (2006, n.p) points to a clear-cut relationship existing between diabetes and cardiovascular comorbidities. He posits that in a study conducted at the Joslin Diabetes Centre, revealed that the relationship between the two comorbidities ranges between a two- and three-fold. This implies that individuals with a heart disease are two or three times likely to occur to patients with diabetes compared to those without diabetes. In particular, Ganda (2006, n.p) further affirms that women with diabetes are also presumed to be at a greater risk of developing cardiovascular complications than women of the same age without diabetes. Similarly, they also posits that cardiovascular disease that leads to stroke or heart attacks is deemed as the most common cause of death for both men and women with diabetes. According to Grundy et.al (2009, pg.1137), there have been a number of breakthrough in the treatment of heart disease over the past decade that have played a significant role in the improving the survival chances of heart victims of heart attack and stroke. Nevertheless, with the increase the in incidences of diabetes, the number of new cases of patients with cardiovascular complications increase. In this regard, Grundy et.al (2009, pg.1137) contends that for patients with diabetes, the rates of improvement and subsequent survival of patients after a fit of a heart attack tends to be less than a half as much as in the general population. Other than just increasing the level of blood glucose in the circulatory system, diabetes interacts with heart diseases in a variety of ways that may result in cardiac myopathy. For instance, the for patients with diabetes, their blood vessels are commonly more susceptible to other risk factors such as high blood pressure and high cholesterol, with an estimated more than 90% of patients reported having one or more of these risk factors. Additionally, prolonged inadequate or poor control of the level of blood glucose level in the circulatory system may lead to cell damage that renders a patient susceptible to heart complications. Ganda (2006, n.p) highlights that diabetic patients commonly have elevated levels of low grade inflammation of the arterial lining, which is associated with changes in blood vessels that may consequently lead to heart diseases. Due their interactivity, the two comorbidities also tend to influence the method health care that a patient should receive. Heath care for such patients should incorporate appropriate means for reducing the risk of the two conditions. For instance, people at risk of diabetes or those with pre-diabetic conditions should consider regular check-up for blood pressure, as well as lipid levels that can be detected and subsequently treated in preventing cardiovascular complications. Systemic factors and the pulmonary factors that contribute to impaired functional capacity in chronic obstructive pulmonary disease Chronic obstructive pulmonary disease (COPD) is one of the major morbidity causes that results in death worldwide, which is mainly caused by smoking. One of the main systemic factors that play a significant role in the impairment of functional capacity in the COPD is pulmonary inflammation. Agusti (2005, pg. 368) points out that the inhalation of exposures may trigger inflammatory responses in the air passages and the alveoli which may impair the respiratory system as a whole. He attributes the inflammation to an increase in the activity of proteases and a subsequent decrease in antiproteases activity. Common proteases include neutrophil elastase and cathepsins that usually breakdown connective tissues in the process of tissue repair, whose activities are normally regulated by antiproteases. In patients with COPD, neutrophils usually exceeds their antiproteases counterparts causing inflammation of the bronchi leading to bronchoconstriction and hypersecretion of mucus that may impair the functional capacity of the respiratory system as a whole. On the other hand, systemic factors that may impair the functional capacity of a COPD patient include fatigue particularly of the skeletal muscle. Wust and Degens (2007, pg. 291) advance that skeletal muscle fatigue the renders vital body muscles unable to hold up certain force or power input. There are multiple causes of muscle fatigue that may compound to worsen the severity of COPD. To begin with, one of the leading causes of the muscle fatigue is hypoxemia that mainly results from the difficulties in breathing that affects oxygen uptake by body cells. Chronic hypoxemia may result general weakness due to muscle wastage, including both the heart and lung muscles rendering the body considerably weak and unable to function to the required level. In addition, chronic hypoxemia may also lead to an increase in pulmonary vascular tone that may consequently renders the pulmonary system impaired due as a result of pulmonary hypertension. Functional impairment among patients with COPP may also be attributed to oxidative stress, which can be regarded as a systemic factor. Oxidative stress mainly arises due elevated levels of free radicals at rest and during exercises. These radicals may find their way to various vital organs ranging from the lungs to the respiratory muscles, and may spill into the circulation system. Prolonged cases of oxidative stress mat lead to acute impairment of the skeletal muscle function, which in the long run may consequently contribute to wasting of the and dysfunction of the respiratory, as well as respiratory muscle (Wust and Degens 2007 pg.289-300). Iatrogenic Disease An iatrogenic disease refers to a physical or mental disease that is presumed to be generated by a physician either intentionally or unintentionally. It commonly entails disorders that induced to a patient by suggestion based on a physician’s manner of diagnosis. It also includes conditions that may occur as a side effect of medical or surgical procedures (Permpongkosol 2011, pg. 77). Whereas some iatrogenic conditions are easy recognize such as those arising from a surgical complication, other may require extensive investigation ranging from the determination of patient-drug interactions among other procedures. Risk factors associated with iatrogenic disease Permpongkosol (2011, pg. 77) posits that iatrogenic diseases usually pose considerable psychomotor impact among other critical social consequences to the victims. In the quest to identify the some of the prevention strategies for this issue, Permpongkosol (2011, pg. 77) proposes the need to identify first patients at high risk for the condition. Among the elderly, there a number of risk factors associated with iatrogenic diseases. To begin with, one of the factors include multiple physicians Permpongkosol (2011, pg. 78) affirms that multiple physicians increases the chances of uncoordinated provision health care with unnecessary medication. As a result, this can lead to either overtreatment or undertreatment. In most cases, each doctor may request for a change in prescription without the other physician’s input. Another risk factor for iatrogenic disease among the elderly may also be attributed to hospitalization, particularly in nursing homes, which exposes the elderlies to possible psychological harm among other communicable diseases. Permpongkosol (2011, pg. 78) alleges that, for patients over 65 years, prolonged stay in intensive care units tend is commonly linked with extended hospital stay. Surgical or medical procedures are also some of the risks factors associated with iatrogenic diseases and complications. In most cases, Permpongkosol (2011, pg. 79) explains that some medical technologies, especially in surgery may contribute to certain iatrogenic complications that may also lead to death. For instance, unwanted prolongation of life using life support machines may pose complications to an elderly patient. Consequences Wise, et al. (2007, PG. 723) seconds Permpongkosol (2011, pg. 80) because of their old age, most elderly patients falling victim of iatrogenic diseases may become suffer from inability to respond to stress due to interference with the patients’ reserve capacity. Furthermore, with cases of multiple chronic conditions common among the elderly, it may become rather difficult to carry out a distinction between the patients’ real symptoms and those of an iatrogenic disease. Some patients may also suffer from long-term psychomotor conditions that may render them dependent on others for the rest of their lives. Prevention The main way of preventing iatrogenic complication mainly entails identification of the patients at risk among the elderly patients (Baine and Kazakov, 2005, pg.166). Subsequently, to be sure of any iatrogenic symptom, care-givers should provide close management of the chronic illnesses that elderly patients have been diagonosed. Permpongkosol (2011, pg. 80) asserts that these complications are preventable and in the event of a reported case, treatment should be administered at the early stages prior to functional incapacitation. References AlvarAgusti, 2005. Systemic Effects of Chronic Obstructive Pulmonary Disease. American Thoracic Society,, Volume 2, pp. 365-370. Dalal, A. A., Shah, M., Lunacsek, O. & Hanania, N. O., 2011. Clinical and economic burden of patients diagnosed with COPD with comorbid cardiovascular disease. Respiratory Medicine, 105(10), pp. 1516-1522. Ganda, O. P., 2006. Diabetes and Cardiovascular Disease. [Online] Available at: http://www.joslin.org/info/diabetes_and_cardiovascular_disease.html [Accessed 4 April 2013]. Goldberg, R. J. et al., 2011. Community trends in the use and characteristics of persons with acute myocardial infarction who are transported by emergency medical services. Heart & Lung: The Journal of Acute and Critical Care, 14(4), pp. 323-333. Grundy, S. M. et al., 2000. Diabetes and Cardiovascular Disease, A Statement for Healthcare Professionals From the American Heart Association. Circulation, Volume 100, pp. 1134-1146. Permpongkosol, S., 2011. Iatrogenic disease in the elderly: risk factors, consequences, and prevention. Clinical Intervention Aging, Volume 6, pp. 77-82. Wise, E. M., O'Brien, t. & Dickson, D. J., 2007. Guidelines causing iatrogenic disease. Rheumatology, 46(4), p. 723. Wust, R. C. & Degens, H., 2007. Factors contributing to muscle wasting and dysfunction in COPD patients. International Journal of Chronic Obstructive Pulmonary Disease, 2(3), pp. 289-330. Read More