The Hospital de la Princesa developed specific programmes for chronic patients.

-the Vice-Counsellor of sanitary assistance from the community of Madrid, Patricia Flores, has opened the day reorientation of the health system facing the challenge of chronic ” which was held last Friday in the Hospital of La Princesa (Madrid), with sponsorship from MSD

-improve the care of chronic patients through tools such as the continuum of care from primary care to the hospital, use of new technologies, home care, efficient use of innovative treatments, etc., contributes to the sustainability of the sanitary system

Madrid, of January 2012- chronic diseases are currently the leading cause of death and disability in the world and represent the most important part of health spending. In fact it is estimated that around 80% of health expenditure is produced by these diseases. From 65 years estimated that each person suffers an average of 2.8 problems or chronic illnesses, reaching an average of 3.23 in older than 75 years, according to data from the national survey of health in 2006, latest available survey of these features.

The ageing of the population and the increase in the prevalence of these diseases in recent years require a change in health systems and in particular a common strategy to deal with the chronicity in Spain that represents a step forward in the improvement of the quality of life for these patients.

The Hospital Universitario de La Princesa, together with the Institute for health research and the collaboration of the MSD company, aware of this issue, have organized the Conference entitled reorientation of the health system facing the challenge of the chronicity. This initiative, which has left several services of the Centre such as internal medicine, rheumatology, Pulmonology, Nephrology, Neurology and UCI, aims to review experiences and tools already being in the Center and raise future projects.

Multidisciplinary programmes for chronic patient

At the meeting, which was inaugurated by the Vice-Counsellor of assistance sanitary Patricia Flores, in the presence of the managing director Miguel Ángel Andrés has been highlighted experiences in it, such as management pluripatológico patient or prevention on the major risk factors for the service of internal medicine; the comprehensive treatment of patients with advanced chronic disease of the Nephrology service; the programme for early discharge of patients with COPD of the Pneumology Service; initiatives in neurological diseases of the Neurology; occupational therapy and control of pain in rheumatoid arthritis in the Rheumatology; of secondary prevention of cardiovascular disease of the internal medicine service; or self-management of patients developed by experts from the intensive care unit.

Also had a space existing nursing consultations, such as the home neumológica of patients with COPD, and Rheumatology. The project on training and information for caregivers will be approached from the role of the figure of the social worker. The opening keynote has pronounced her professor of preventive medicine and health public of the University autonomous of the community of Madrid, Fernando Rodriguez who spoke about the challenges in developing a strategy for tackling of the chronicity in Spain.

Comprehensive care for chronic patients, a priority

One of the speakers at the seminar, Dr. Manuel Ollero, director of the clinical unit of medicine internal (UCAMI) of the Hospital Universitario Virgen del Rocío has stressed that is a priority to provide comprehensive care to the patient and ensure the continuity of care between primary and hospital care to deal with the challenge of chronic ”.

Says Dr. Potter in his unit different changes that have contributed to cope with the new model of continuum of care have been made and that they are beginning to incorporate in other Spanish hospitals. Highlights his experience in measures such as the development of the figure of the internist of reference in each health centre and the creation of the unit’s day, which brings together the consultations of high resolution and hospital day. have also reorganized the welfare work of the internist to enhance continuity in the doctor-patient relationshipwhich is essential for proper management of patients with more than one pathology ”.

Another example of projects aimed at improving the care of the chronic patient is undertaken in the Basque country, following one of the models of reference at European level, known by its acronym in English as CCM (Chronic Care Model). Mr. Roberto Nuño, Director of the Basque Institute for health innovation, explains that after a process of review of the areas of intervention of the CCM, a group of Spanish institutions and professionals has developed and validated a self-assessment tool adapted to our health care system, called IEMAC (evaluation instrument, models of care to the chronicity), “a very useful tool that helps to reorient the system health partner led to chronic patient because it measures the basal position of each system as well as the progress obtained from interventions of improvement ”.

“The Medical Director of the Center, Dr. Javier Aspa, one of the main promoters of the meeting, has been responsible for exposing some of the conclusions of the working day stating that is clear that before the advance of chronic diseases is necessary to be more efficient to offering a continuum of care throughout life, with the potential addition of preventing unnecessary hospitalizations; This requires measures such as the availability of records of chronic patients, the development of educational materials, the involvement of nurses in the management of complex patients and coordination between levels care. ”