Although the cause of diabetes is unknown, it appears that genetic, lifestyle, Diabetes It will help people with diabetes get the information needed to …
Hawaii Health Performance In Action
An Update of the Hawaii Health Performance Plan H2P2
Spring, May 2000 Volume 2 Number 2
Hawaii Health Performance Plan H2P2
A
S the State of Hawaiis health planning and resources and development
program SHPDA is mandated to develop a state health services and
facilities plan which shall address the health care needs of the State
The Hawaii Health Performance Plan or H2P2 is a community driven and
comprehensive health plan It includes performance outcome measures to
guide the development of health care in our State
H2P2 is a living document that we constantly strive to improve We are
working with communities, who identified health issues and are working on
solutions to address these issues
FOCUS ONChapter VI - Diabetes and Other Chronic Disabling Conditions
J
amie Cameros, Chapter Facilitator, representing Kaiser Permanente, found
that chronic disabling conditions surround us
In 1995, an estimated 99 million people in the United States had a
chronic condition By 2030, it is estimated that this number will increase
to 150 million
Americans Forty two million of these Americans will be
limited in their ability to go to school, to work, or to live
independently
Providing adequate services for people with chronic conditions has
significant implications for national health care expenditures In 1990,
470 billion was spent on the direct costs of medical care for people with
chronic conditions This does not take into account indirect costs for
lost productivity or socio psychological costs associated with people who
have chronic conditions
The health care delivery system must evolve to provide cost-effective
and coordinated health care for the growing number of Americans with
chronic health conditions Chronic conditions call for care that includes
an integrated network of professionals with a great reliance on non-
professional and informal caregiving - that is, on family, friends, and
community-level organizations
The goal of chronic care is not to cure Rather, to help individuals
with chronic conditions maintain independence and a high level of
functioning?
State Health Planning and Development Agency
SHPDA
Governor:
Benjamin J Cayetano
Administrator: Marilyn A Matsunaga
STATE HEALTH COORDINATING COUNCIL:
Randy Perreira, Chair
Winifred Odo, Chair, CON Review Panel
Jim Walsh, Chair, Plan Development Committee
SUBAREA HEALTH PLANNING COUNCILS:
Abel Medeiros, Chair Kauai County
Lane Uchimura, Chair Honolulu
Laurie Oishi, Chair West Oahu
Ann Ditzler, Chair Windward Oahu
Catherine Nobriga Kim Maui County
Beverly Jean Withington Hawaii County
STAFF:
Clarysse Kami Nunokawa, Planner
Leatrice Tsubota, Planner
Ken Yoshida, Research Statistician
Amy Ichiyama, Secretary
Tina Vidinha, Clerk Typist
Patrick Boland, Branch Chief
FOCUS ONAlzheimers Disease
A
lzheimers Disease is the fourth leading cause of death in adults It is a
progressive and degenerative disease that attacks the brain and results in
impaired memory, thinking and behavior
Alzheimers Disease is a heavy economic burden on society A recent
study estimated that the cost of caring for a patient with severe cognitive
impairment at home or in a nursing home is more than 47,000 a year For a
disease that can span from 2 to 20 years, the overall cost to families and
society is
staggering
It is estimated that 17,000 people in Hawaii have Alzheimers Disease
However, only a small number are formally diagnosed, making it a relatively
under-diagnosed condition
RECOMMENDATION
Alzheimers Disease
1 Screening Programs and Public Education designed to increase aware-ness
of the early signs of Alzheimers Disease will help get people into
needed treatment
2 Access to Specialty Care to improve quality of life for the Alzheimers
patient and their family members
3 Community Support Services such as Alzheimers specific day care,
respite care, and skilled nursing must increase
4 Patient and Family Caregiver Support Groups and Counseling should be
made available to patients and family members to help them cope with the
disease
5 Long Term Care programs that are cost-effective must be made available
6 Research aimed at improving diagnosis and therapeutic effectiveness must
increase
FOCUS ONAsthma
A
sthma is the Greek word for panting It is a condition that causes
inflammation and obstruction of the airways
Asthma usually develops in childhood The first episode often follows a
cold or the flu
and is more common in children who are exposed to cigarette
smoke in the home Many children outgrow asthma but will still be at risk
as adults Most children and adults can control their asthma by avoiding
triggers that cause attacks and using medications to manage symptoms
Many things can trigger asthma, including allergens, exercise, cigarette
smoke, changes in weather, and colds or the flu
Approximately 100,700 people in Hawaii have some form of asthma and they
account for 88 of the state population 1996 Health Surveillance Survey
The distribution of prevalence rates by region shows the residents of
Kauai have the highest rate of asthma and residents of Honolulu have the
lowest rate
RECOMMENDATION Asthma
A
concerted effort by the community, health care providers, and the patient
is needed to address:
1 Environment Control Measures
- Reduce to zero the emissions of air pollutants above permit levels
- Explore improved extermination measures
- Reduce exposure to environmental tobacco smoke
2 Coordinated Health Care
- Prevent chronic and troublesome symptoms
- Maintain near normal pulmonary function
- Maintain
normal activity levels
- Prevent recurrent asthma attacks and minimize the need for emergency
visits or hospitalization
3 Patient Education An educated patient can participate in self-
management and is more likely to adhere to treatment programs
Culturally sensitive patient education is also essential
IN ACTIONWindward Subarea Health Planning Council
D
id you know that Windward Oahu residents have the second highest rate of
asthma in the State? Because of this fact, the Windward Oahu SAC is
focusing its efforts on asthma prevention and education
Examples of some of their activities are:
Initiated and facilitates the Asthma Coalition that brings together key
players to address asthma issues in Windward Oahu
Public awareness campaigns
Windward Oahus first ever, Asthma Data and Resource Book with specific
Windward Oahu data and resources
Pilot programs for kids in school and their parents in collaboration with
the Department of Education, the American Lung Association and others
Pursue additional funding for research and evaluation activities
FOCUS ONDiabetes
D
iabetes is a major cause
of disability and death in Hawaii With
diabetes, the body does not produce or properly use insulin, which is a
hormone needed to convert sugar, starches, and other food into the energy
required to support life functions Although the cause of diabetes is
unknown, it appears that genetic, lifestyle, and environmental factors play
a major role in developing diabetes At this time, there is no cure
Approximately 52,000 people in Hawaii have some form of diabetes
Creating a Surveillance System for Diabetes in Hawaii, 1996 The
prevalence in Hawaii is 48 higher than the national prevalence rate
Diabetes is know as a silent killer because many people dont know they
have diabetes until they develop one or more of its life-threatening
complications:
- Blindness Diabetes is the leading cause of blindness for people ages 20
- 74
- Kidney Disease affects 10-20 of people with diabetes For many
diabetics with kidney disease, their condition gradually deteriorates to
outright kidney failure
State Health Planning and Development Agency
1177 Alakea Street, room 402
Honolulu, Hawaii 96813
Phone: 587-0788
Fax:
587-0783
e-mail: shpda@healthstatehius
wwwhawaiigov/health/shpdahtm
The best health care website in Hawaii
- Nerve Disease and Amputation affects approximately 60-70 of people with
diabetes In severe cases, it can lead to lower limb amputation
- Heart Disease/Stroke is present in nearly 75 of all diabetes-related
deaths People with diabetes are two to four times more likely to suffer
a stroke or develop cardiovascular disease
RECOMMENDATION Diabetes
I
t is imperative that people with diabetes have their condition under
personal control and are monitored by coordinated health care teams
Access to affordable and quality health care is essential To facilitate
access to care we must work to prohibit pre-existing condition exclusions
and pro-
vide coverage for prescription drugs and insulin and diabetes-related
supplies, equipment and education
Health Care Team Education is vital People with diabetes have a multi-
system disease; a team approach that involves screening, enrollment,
treatment and monitoring is best
Patient Education is critical It will help people with diabetes get the
information needed
to reduce their risk for complications through
education and controlling their blood glucose levels
———————–
Table of Contents
Page 2 Focus on Alzheimers Disease
Page 3 Focus on Asthma
Page 4 Focus on Diabetes
