HEALTH MAINTENANCE AND PREVENTION

Health Maintenance and Prevention

Health Maintenance and Prevention

Health maintenance is the concept of improving or sustaining the health outcomes and quality of life of populations with chronic conditions while reducing the cost of healthcare. The aim of Health maintenance programs is to prevent and minimize the effects of chronic conditions or disease in which patient self-care plays an important role. This is achieved through a systematic, population-based approach of identifying individuals who are at risk, intervening through targeted programs, using evidence-based guidelines, and measuring the results and outcomes of these efforts. The model of Health maintenance focuses on coordinating a continuum of care for populations with similar or the same chronic conditions. (McAlister, 2002)

Nature of Problem

The Health maintenance process entails the substantial use of data to meet the program goals as well as to ensure its effectiveness. Claims data analyses are used to evaluate which medical condition or conditions are the most costly as well as to determine the prevalence of disease within a given population.

Health maintenance programs are generally designed with the intent of improving care while reducing costs in the long term. Therefore, the next step is to identify the segment of patients with the identified condition(s) who have the highest cost and utilization patterns. The results from the claims data analysis can be used to guide the selection of the patient population that will be targeted for Health maintenance. By analyzing patient utilization patterns, the Pareto principle generally holds that a small proportion of patients account for the vast majority of the total costs. (Linden, 2007)

Steps for Quality Improvement

The intervention is the central aspect in the implementation of Health maintenance programs and entails both provider and patient participation. Disease intervention must include both prevention and the proper treatment and management of the given ...