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Preventing and Managing Chronic Disease


The full document, Preventing and Managing Chronic Disease : Ontario’s Framework, is available for download below.

A variety of chronic disease prevention and management success stories in Ontario are also available.

Ontario's Framework

In Ontario, as is the case in developed countries throughout the world, chronic diseases are the leading cause of death and disability. Almost 80% of Ontarians over the age of 45 have a chronic condition. Of those, approximately 70% suffer from two or more chronic conditions. (CCHS, 2003) Left untreated or managed poorly, chronic conditions can deteriorate and predispose individuals to other chronic conditions. In Ontario the economic burden of chronic disease is estimated to be 55% of total direct and indirect health costs.

The good news is that there is great potential to improve health outcomes and reduce the burden of chronic disease.

Evidence from other jurisdictions and innovative practices within Ontario make it clear that what is needed is a fundamentally different way of addressing chronic disease – a systems approach to prevention and management that :

Although Ontario is making inroads, it can do much to improve its approach to chronic disease prevention and management. That is why the Ministry of Health and Long-term Care has developed a framework to guide the redesign of health care practices and systems to improve the prevention and management of chronic disease. The Framework is based on models that have been used successfully in other jurisdictions, including the U.S., U.K., Australia, New Zealand and parts of Europe, as well as in British Columbia, Alberta, Saskatchewan and Manitoba.

Ontario’s Chronic Disease Prevention and Management Framework identifies a cluster of interconnected and mutually dependent practice and system changes that have been found to be effective in preventing and managing chronic disease. It consists of the following components :

In addition to the Framework, the ministry has developed a CDPM (chronic disease prevention and management) Logic Model. The CDPM Logic Model is a visual representation of the CDPM Framework, showing how specific activities contribute to better health and system outcomes and, can be used to develop performance indicators. This tool, in conjunction with the Framework, is being used for chronic disease planning and evaluation by the Ministry of Health and Long-Term Care, the Ministry of Health Promotion, LHINs, health organizations and providers

The CDPM Logic Model is a visual representation of the CDPM Framework, showing how specific activities contribute to better health and system outcomes and, can be used to develop performance indicators. The Priority Setting Decision Tool provides two methodologies to compare the burden of illness of a number of chronic diseases and can be used to help set chronic disease priorities. The tool is primarily intended to provide a methodology for local adaptation, the data given should only be treated as examples.

The best research evidence indicates that the approach of the Framework will improve the health and functioning of chronically ill Ontarians and reduce the incidence of chronic disease in the province. People will receive quality care from the right provider in the right setting at the right time and their clinical outcomes and quality of life will be better. Health care providers will be able to provide higher quality care and they will experience greater job satisfaction.

The evidence also suggests that the approach uses health system resources more efficiently and avoids costs: emergency departments are used less, there are fewer hospitalizations, and less duplication of services. The Framework approach will lead to a system that mobilizes health care organizations, individuals and their families, and communities in the effective prevention and management of chronic disease.

Document Download

Preventing and Managing Chronic Disease : Ontario’s Framework
50 pages | 458 kb | PDF format

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