Critical Reflections on Self-Management Support in Chronic Disease: The Value of Occupational Therapy in Health Promotion

摘要

Amid debate regarding the particulars of reform, the landscape of health care is changing. Theincreasing burden of chronic disease, combined with a recognition of soaring health care costs, demandsa reexamination of established models of care. Traditional services are reactive and emphasize diseasefocusedand episode-specific remediation. These frameworks fragment care between providers andsettings, thus limiting outcomes and inflating costs and use. A shift, therefore, to integrated proactivemodels of care that emphasize a continuum of intervention and prevention is advocated. Such a shift isimportant to promote individual, community, and population health while decreasing costs (Institute ofMedicine [IOM], 2003; Leland, Fogelberg, Halle, & Mroz, 2016).