Chronic health conditions have been identiﬁed as a key challenge for health care during the twenty-ﬁrst century.Chronic conditions affect a signiﬁcant proportion of the population, not only in Canada, but around the world. The majority of health care services are used by individuals with chronic conditions 5 and the cost of treating chronic conditions is signiﬁcant. In Canada, 67 per cent of total direct health care costs and 60 per cent of indirect costs in terms of lost productivity and foregone income are attributed to chronic diseases.
Chronic health conditions are those expected to persist or to recur, usually beyond one year, and range from persistent skin disorders such as psoriasis, to recurrent psychosocial conditions such as chronic depression, to complex, high impact conditions such as chronic renal failure, congestive heart failure, and cerebrovascular disease. Chronic conditions are signiﬁcantly associated with increasing age and gender, and lower socioeconomic status,and include both diseases such as diabetes, and health states involving disability, such as post-stroke impairment. As the population ages, the needs of people with chronic conditions are expected to place increasing demands on health care providers and health care delivery systems. The impact of chronic conditions and the need to introduce chronic condition prevention has been identiﬁed as a priority for the newly created Public Health Agency of Canada.
The Romanow Commission on the Future of Health Care in Canada also identiﬁed the needs of those with chronic conditions as an area for future attention, and the recent national consultation on health services and policy issues for 2004–2007, Listening for Direction II, identiﬁed chronic disease management as an important issue for sustainability in Canada.