Washington, DC has substantial challenges in effectively supporting residents who are living with, or at risk of, chronic conditions. Certain chronic conditions, including cardio-vascular disease, diabetes, chronic kidney disease, stroke, hypertension, and chronic obstructive lung disease, often lead to death and have common causes. Additionally, most people who live with one of these conditions eventually will live with more than one. Optimal service delivery would promote aggressive reduction of risk factors to delay disease progression, self-care education, relief of symptoms, rapid response to worsening status, advance care planning, and modification of the illness through medical interventions when appropriate. Unfortunately, typical care in DC shows substantial shortcomings on each of these elements. Patients often do not fully understand their conditions and lack skills and training in self-care. They experience repeated (and often avoidable) hospitalizations. Errors in medication management, especially at the time of changes in setting of care, are not uncommon. The available evidence demonstrates that DC has very high expenditures on health services and yet provides services that are of unreliable quality across time. The Chronic Care Coalition seeks to change the status quo by facilitating a system of care that reliably and efficiently prevents chronic disease and treats and supports those District of Columbia residents affected by, or at risk of, a chronic condition.
