Many diseases, one model of care?

Abstract

Patients with multiple chronic conditions (multimorbidity) have complex and extensive health and social care needs that are not well served by current silo-based models of care. A lack of integration between care providers often leads to fragmented, incomplete, and ineffective care, leaving many patients overwhelmed and unable to navigate their way towards better health outcomes. In planning for the future, healthcare policies and models of care are required that cater for the complex needs of patients with multimorbidity and that deliver coordinated care that is patient-centred and focused on disease prevention, multidisciplinary teamwork and shared decision-making, and on empowering patients to self-manage. Salient lessons can be learnt from the work undertaken at a European and national level to develop care models in cancer and diabetes - two complex and often co-occurring conditions requiring coordinated long-term care. Innovative work is also underway in many European countries aimed at improving the integration of care for people with multimorbidity, resulting in more efficient and cost-effective health outcomes. This article reviews some of the most innovative programmes that have been initiated across and within Europe with the aim of improving the way care is delivered to people with complex and multiple long-term conditions. This work provides a foundation upon which to build better, more effective models of care for people with multimorbidity.

Keywords: Cancer Control Joint Action (CanCon); European Partnership for Action Against Cancer (EPAAC); Innovating Care for People with Chronic Conditions in Europe (ICARE4EU) project; Multimorbidity; comorbidity; diabetes; literacy; multiple chronic conditions.

Figure 1

Percentage of care providers involved in selected integrated care programmes directed at multimorbidity (n=101) [11]. Reproduced from van der Heide I, et al. Innovating care for people with multiple chronic conditions in Europe: an overview. Utrecht: NIVEL; 2015. Available from: http://www.icare4eu.org/pdf/State-of-the-Art_report_ICARE4EU.pdf