Chronic disease is driving up healthcare costs

Chronic disease is rapidly increasing worldwide, and is becoming a burden on healthcare systems globally. Interestingly, the main cost driver seems to be not so much chronic disease itself, as the complications around patients not managing it correctly. In South Africa, only 10% of patients have one or more chronic conditions, but they consume more than 50% of all healthcare spend.

The programme is still in its early stages, but already it’s clear that patients with chronic illness who manage to see their doctor more than once a year are more likely to comply fully with their treatment plan. This is significantly higher than for patients in a non-facilitated environment, and matches the results of the best pilot programmes.

Why don’t patients help themselves?

Why patients don’t change their behaviour when diagnosed with a chronic disease is a widely studied topic. A major reason is that not all individuals at risk feel ill. Some risks are considered “acceptable”, and are not sufficient to motivate a change in behaviour. Change is more likely when there is a combination of knowledge, attitudes, skills – and most importantly, the environment, including access to multi-disciplinary teams of doctors and nurses. And patient engagement is also important.

Pilot study shows encouraging trend

A pilot programme with a leading healthcare provider group and Healthbridge is currently under way. It aims to help patients manage their chronic disease with the use of a technology platform that records and tracks key clinical metrics, making it simpler for the doctor and nurse to engage with them.

Patients with chronic conditions are all at unique stages of their condition, belong to different medical schemes requiring different treatment guidelines, and require different levels of engagement. The technology helps medical practitioners to identify what stage a patient is at a glance, so that they can proactively schedule appointments, and remind them about check-ups and preventative measures. Most importantly, patients are urged to take responsibility for their own health, and for adhering to their treatment plans.

Early signs of success

The trends are interesting. The graph alongside is from one of the pilot studies that focuses on patients with diabetes. What it shows is that there is a high degree of participation in the programme in some form or another, whether patients just having enrolled (90%), partially engaged (75% completed more than one visit) or full participation (30%). Patients who participated fully followed their treatment plan in terms of both required visits and activities.


In practice, managing chronic disease should be an easy task, especially when one adheres to evidence-based guidelines, both local and international (World Health Organisation). However, “motivating the patient” is often problematic, because they are reluctant to change their behaviour. As a medical practitioner, actively considering a patient engagement strategy can assist with some of this complexity, even if it means implementing new processes or technology. You’ll see the benefits when your patients are more engaged and follow their treatment plans, ultimately leading to their improved health.

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