title: The role of pulmonology in the National Health System Chronicity Strategy.
abstract: Longer life expectancy and the progressive aging of the population is changing the epidemiological pattern of healthcare, with a reduction in the incidence of acute diseases and a marked increase in chronic diseases. This change brings important social, healthcare and economic consequences that call for a reorganization of patient care. In this respect, the Spanish National Health System has developed a Chronicity strategy that proposes a substantial change in focus from traditional rescue medicine to patient- and environment-centered care, with a planned, proactive, participative and multidisciplinary approach. Some of the more common chronic diseases are respiratory. In COPD, this integrated approach has been effective in reducing exacerbations, improving quality of life, and even reducing costs. However, the wide variety of management strategies, not only in COPD but also in asthma and other respiratory diseases, makes it difficult to draw definitive conclusions. Pulmonologists can and must participate in the new chronicity models and contribute their knowledge, experience, innovation, research, and special expertise to the development of these new paradigms.
authors.affiliation: Servicio de neumología, Hospital Arnau de Vilanova, Valencia, España; CIBER de Enfermedades Respiratorias (CIBERES), España. Electronic address: jjsoler@telefonica.net.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Soler-Cataluña
authors.affiliation: Servicio de neumología, Hospital Arnau de Vilanova, Valencia, España.
authors.forename: Fernando
authors.initials: F
authors.lastname: Sánchez Toril
authors.affiliation: Servicio de neumología, Hospital Arnau de Vilanova, Valencia, España.
authors.forename: M Carmen
authors.initials: MC
authors.lastname: Aguar Benito
mesh_terms: D001249:Asthma / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D002908:Chronic Disease / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D017046:Cost Savings; D019033:Delivery of Health Care, Integrated / Q000191:economics / Q000458:organization & administration*; D019468:Disease Management; D006801:Humans; D033183:Interdisciplinary Communication; D008962:Models, Theoretical; D009313:National Health Programs / Q000191:economics / Q000458:organization & administration*; D010348:Patient Care Team; D010353:Patient Education as Topic; D011369:Professional-Patient Relations; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D015272:Pulmonary Medicine / Q000458:organization & administration; D011788:Quality of Life; D012120:Respiration Disorders / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D013030:Spain / Q000453:epidemiology; D014944:World Health Organization
keywords: Asma; Asthma; Atención integral; Case-management program; Chronic disease; Chronic obstructive pulmonary disease; Cronicidad; Disease-management program; Enfermedad pulmonar obstructiva crónica; Gestión de casos; Gestión de enfermedad; Integrated care program