Preventive solutions for a healthy future

Integrating prevention into health care

Due to public health successes, populations are ageing and increasingly, people are living with one or more chronic conditions for decades. This places new, long-term demands on health care systems. Not only are chronic conditions projected to be the leading cause of disability throughout the world by the year 2020; if not successfully prevented and managed, they will become the most expensive problems faced by our healthcare systems. People with diabetes, for example, generate healthcare costs that are two to three times those without the condition, and the costs of lost production due to diabetes are estimated to be five times the direct healthcare costs. In this respect, chronic conditions pose a threat to all countries from a health and economic standpoint.

Many costly and disabling conditions - cardiovascular diseases, cancer, diabetes and chronic respiratory diseases - are linked by common preventable risk factors. Tobacco use, prolonged, unhealthy nutrition, physical inactivity, and excessive alcohol use are major causes and risk factors for these conditions. Trends in tobacco use will increase in the foreseeable future especially in developing countries. The ongoing nutritional transition expressed through increased consumption of high fat and high salt food products will contribute to the rising burden of heart disease, stroke, obesity and diabetes. Changes in activity patterns as a consequence of the rise of motorized transport, sedentary leisure time activities such as television watching will lead to physical inactivity in all but the poorest populations. Many diseases can be prevented, yet health care systems do not make the best use of their available resources to support this process. All too often, health care workers fail to seize patient interactions as opportunities to inform patients about health promotion and disease prevention strategies.

Essential elements for action

• Support a paradigm shift towards integrated, preventive health care
• Promote financing systems and policies that support prevention in health care
• Equip patients with needed information, motivation, and skills in prevention and self-management
• Make prevention an element of every health care interaction
• In the past three decades great strides have been made in preventing and treating heart disease and stroke. Death rates from cardiovascular disease have declined as a result, mainly because so many people have made positive behavior and lifestyle changes.

Why is preventive health care so important?

• About half of all deaths from heart disease are sudden and unexpected, so there's little opportunity for treatment. For people at risk of sudden death, prevention is the key.
• Atherosclerosis often begins in childhood, but it may be decades before clinical disease shows up. We don't fully understand all the causes of heart disease, but many population studies have identified major risk factors and strategies to reduce the risk. These are the risk factors we can modify, treat or control:
• tobacco smoke
• high blood cholesterol
• high blood pressure
• physical inactivity
• obesity and overweight
• diabetes mellitus

Public health decision makers in developed and developing countries are exploring the idea of providing packages of health checks at specific times during a person's lifetime to detect and/or prevent life-threatening diseases such as diabetes, heart problems, and some cancers. Bundling together tests for different diseases has advantages for both health-care systems and patients. It can save time and money for both parties and, by associating health checks with life events such as childbirth, it can take advantage of a valuable opportunity to check on the overall health of individuals who may otherwise rarely visit a doctor.

Manipal Cure and care has specifically re-engineered the Health check medical processes to cater to health concerns lurking in the minds of the most time pressed individuals. The demanding work life in today's fast paced world leaves very little time for people to address their health issues.

MCC XPresscare packages: Xpress care is an organ specific walk in check done in a short span of 45 minutes, especially created for retail health care setting to cater to the time pressed individuals. These are:

• Livercare
• Kidneycare
• Lungcare
• Diabcare
• Rheumacare
• PostExposurecare

Just to give an example, if one has a lot of craving for sweets, when he knows that his parents had diabetes, he could undergo the Diabcare package in a short span of 45 minutes, which is based on international best practice guidelines that have been customized to our country, and this would allay all concerns about his diabetic status. If a person has an impaired glucose test then he can be immediately tracked to full diagnosis and management where a comprehensive cover is done by checking the laboratory parameters, eye check and cardiac and kidney parameters. In MCC one goes to the extent of testing for peripheral neuropathy thereby, enhancing the experience and enabling an all round, one stop care for the individual. It is of course ensured that it is done by qualified medical professionals who are trained in diabetes management.

In a different scenario, a person who is a chronic alcoholic could avail MCC Livercare package to know about his liver status.

Similarly, a chronic smoker could get his lung status report by undergoing the 45 minutes MCC Lungcare package.

Additionally, an exclusive package called Post-exposure care is also there for those who have had an unsafe contact. This is completed in a span of just 45 minutes under complete confidentiality.

MCC Scheduled health packages which require a person to undergo health check with certain pre-requisites, is also there. These are time audited to be completed within 3 to 4 hours as compared to similar packages given by other healthcare settings where the turnaround time is 6-8 hours. These are delivered by health professionals who are sensitized to handle relevant health check queries and ensure that the guest not only gets a health check but also builds a bond recreating the aura of the traditional family doctor. Qualified technicians do the investigations supervised by professionals and standard operating processes. Counselors are there to ensure smiling and cheerful information exchange in a totally non-hospital colorful atmosphere.

Various scheduled health checks are:

• Basic
• Advanced
• Executive
• Master
• Woman
• Child

MCC also has a package to cater to the whole family- Family Package where both parents and one child is covered.

Special customized packages for corporates are there also for various multinationals.

The medical process re-engineering at MCC does not end here, but goes beyond to create specific packages for children who are the future of the country and today are more susceptible to lifestyle disorders like obesity, emotional problems and preventable health issues delivered by diet consultants, clinical psychologists and Pediatricians.

Knowing that Indian population is ageing, MCC also has customized packages for golden age (geriatric) guests for screening and maintenance of chronic lifestyle disorders.

To ensure safety, all the above is delivered by equipments that are US FDA and CE certified. For the first time, there are offerings with direct linkage to Electronic Medical Record. Error proofing of clinical process is done to ensure safety of the guest in delivery of medical processes.

On analyzing the trend in the actual statistics in MCC, it has been observed that Male packages and Female packages have done equally well. This is a very good trend as it shows that both men and women are now not only aware and concerned about their wellness, they are accessing healthcare screening facility on a similar pattern with equal enthusiasm. Of course the Xpress care packages like Lung care and Rheuma check have been taken more by men as compared to women.

The age groups identified who are accessing these packages are between 25-40 years. Thus, we may conclude that we may do more health awareness amongst the elderly who are not accessing the preventive services as much as they should.

Infectious Disease Specialist Medical Director Manipal Cure and Care