Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Sep 16;6(2):95-102.
doi: 10.15256/joc.2016.6.81. eCollection 2016.

Involving patients with multimorbidity in service planning: perspectives on continuity and care coordination

Michaela L Schiøtz  1 , Dorte Høst  1 , Anne Frølich  1
Affiliations

Involving patients with multimorbidity in service planning: perspectives on continuity and care coordination

Michaela L Schiøtz et al. J Comorb. .

Abstract

Background: The prevalence of multiple comorbid chronic conditions, or multimorbidity, is increasing. Care provided to people with multimorbidity is often fragmented, incomplete, inefficient, and ineffective. As part of a research and development project focusing on improving care, we sought to involve patients with multimorbidity in the planning process.

Objective: To identify opportunities for improving care by understanding how patients from a Danish University Hospital experience care coordination.

Design: Qualitative semi-structured interviews with 14 patients with multimorbidity.

Results: Patients with multimorbidity described important concerns about care that included: (1) disease-centered, rather than patient-centered, care; (2) lack of attention to comorbidities and patient preferences and needs; and (3) involvement of numerous healthcare providers with limited care coordination. Poor continuity of care resulted in lack of treatment for complex problems, such as pain and mental health issues, medication errors, adverse events, and a feeling of being lost in the system. Receiving care from generalists (e.g. general practitioners and healthcare professionals at prevention centers) and having a care coordinator seemed to improve patients' experience of continuity and coordination of care. Suggestions for service improvements when providing care for people with multimorbidity included using care coordinators, longer consultation times, consultations specifically addressing follow-up on prescribed medications, and shifting the focus of care from disease states to patients' overall health status.

Conclusions: A need exists for a reorganization of care delivery for people with multimorbidity that focuses on improved care coordination and puts patient preferences at the center of care.

Keywords: Comorbidity; integrated care; multimorbidity; patient satisfaction; qualitative research; user involvement.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflicts of interest.

References

    1. Fortin M, Bravo G, Hudon C, Vanasse A, Lapointe L. Prevalence of multimorbidity among adults seen in family practice. Ann Fam Med. 2005;3:223–8. View Item. - DOI - PMC - PubMed
    1. Marengoni A, Angleman S, Melis R, Mangialasche F, Karo A, Garmen A, et al. Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev. 2011;10:430–9. View Item. - DOI - PubMed
    1. Fortin M, Lapointe L, Hudon C, Vanasse A, Ntetu AL, Maltais D. Multimorbidity and quality of life in primary care: a systematic review. Health Qual Life Outcomes. 2004;2:51. View Item. - DOI - PMC - PubMed
    1. Fortin M, Bravo G, Hudon C, Lapointe L, Almirall J, Dubois MF, et al. Relationship between multimorbidity and health-related quality of life of patients in primary care. Qual Life Res. 2006;15:83–91. View Item. - DOI - PubMed
    1. Condelius A, Edberg AK, Jakobsson U, Hallberg IR. Hospital admissions among people 65+ related to multimorbidity, municipal and outpatient care. Arch Gerontol Geriatr. 2008;46:41–55. View Item. - DOI - PubMed

LinkOut - more resources