Chronic Medical Conditions and Care Complexity

April 1, 2021
April 1, 2021

The aging of the American population is spurring the increased focus on efforts to provide better care for people with chronic conditions. This is the message of the HealthStream article, Manageable but Often Overlooked: Chronic Disease Treatment Will Play a Vital Role in Effective Population Health Efforts.

About Chronic Medical Conditions

There are many medical conditions deemed as chronic. In terms of population health management today, there are a handful that have become most prevalent in discussions around ongoing care, due to their treatment complexity and rising number of patients:

  • Alzheimer’s Disease & Dementia
  • Arthritis
  • Asthma
  • Cancer
  • Chronic Kidney Disease
  • Chronic Urinary Tract Infections
  • COPD
  • Crohn’s Disease
  • Depression & Suicide in Oder Adults
  • Diabetes
  • Dysrhythmia
  • Epilepsy
  • High Blood Pressure/High Cholesterol
  • Ischemic Heart Disease
  • Multiple Sclerosis
  • Osteoporosis
  • Parkinson’s
  • Stroke
  • Ulcerative Colitis

Each on its own poses a thorny problem for care providers, but often a patient may present with one or more conditions concurrently, creating an even more complex case.

Claiming a Major Portion of Healthcare Resources

These patients claim an outsized portion of healthcare resources, and it’s not just in-facility treatments that run up the costs. Often chronic conditions require the intervention and aid of social workers and others who operate alongside healthcare providers, creating a larger community of support within the overall population. That care team must consider the patient’s entire life, where they live and work, as well as their access to exercise and quality food, to create a treatment plan that is not only effective but practical (Kent, 2018). Much work is now being done to target patients with a particular chronic condition and treat them as a separate population. This isn’t to isolate them, but rather to create a way for their unique circumstances to be factored into any treatment—hopefully building a scenario where they are more likely to respond and cooperate. What would that look like? In most every instance, a team-based approach appears to be the most effective in terms of expense and outcome:


The CDC reports that more than 29 million Americans currently live with diabetes, and another 84 million are prediabetic. Many more are likely undiagnosed and, therefore, untreated (Kent, 2018). All told, they represent more than 20 percent of healthcare spending. Since these patients are sometimes minorities or economically challenged, providers have begun to create personalized adherence plans in tandem with community, pharmacy, and public health resources in order to improve adherence rates. Those can include text messages and other tools to boost non-office patient engagement and improve outcomes (Kent, 2018).


One in three American adults suffers from hypertension, which often tracks alongside heart disease and stroke, two of the CDC’s leading causes of death in the United States. The same collaborative approach is being undertaken by healthcare providers around the country, who are working to engage patients and educate them on methodologies and medications that can reduce and control their blood pressure.

COPD and Asthma

Another set of alarming numbers: The CDC says more than 15 million Americans have received a chronic obstructive pulmonary disease, or COPD, diagnosis, while asthma affects another estimated 25 million individuals. Many of those with COPD are older, and often smokers, so cessation is a big part of their treatment as a population. There is also a growing roster of programs designed to teach COPD and asthma sufferers how to more accurately use inhalers and other breathing devices in order to achieve maximum treatment efficacy.

Depression/Mood Disorders

While depression may present on its own, the illness also often turns up alongside another chronic disease as the patient copes with the psycho-emotional challenges brought on by a diagnosis. Often, that new information is not accompanied with any kind of mental health screening or treatment protocol, either of which could significantly improve outcomes by allowing for mental health providers to be engaged alongside their medical counterparts (Bresnick, 2017).

This article also includes:

  • Focusing More on Populations That Require More Care
  • Demographic Urgency: Growing Senior Population Provides Impetus for Quick Action
  • No Magic Bullet, No Single Approach Method
  • Population Management Allows for Targeted Treatment


Kent, Jessica. “Addressing Chronic Disease with Population Health Management Strategies.” July 12, 2018. Accessed April 8, 2018. https://healthitanalytics. com/news/addressing-chronic-disease-with-population-health-management-strategies.


Download the full article here.