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Care coordination of multimorbidity: a scoping study.

Anne Doessing1, Viola Burau

  • 1VIA University College, School of Continuing Education, Centre for Leadership and Organisation Development (CLOU), Aarhus, Denmark.

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|November 2, 2017
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Summary

Managing patients with multimorbidity requires addressing complex care coordination. This study reveals that complexity exists at both patient and organizational levels, necessitating new intervention strategies.

Keywords:
Multimorbiditycare coordinationchronic diseasecomplexitydisease managementintegrated care

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Area of Science:

  • Healthcare Systems Research
  • Public Health
  • Health Services Management

Background:

  • Healthcare systems globally face challenges managing multimorbidity, often operating within single-disease frameworks.
  • Multimorbidity, the co-occurrence of multiple chronic conditions, affects a significant patient population.
  • Existing healthcare structures are ill-equipped to handle the complexities of patients with multiple health issues.

Purpose of the Study:

  • To characterize care coordination for patients with multimorbidity.
  • To identify factors influencing care coordination at organizational and professional levels.
  • To explore preconditions for effective care coordination in complex patient cases.

Main Methods:

  • A scoping study methodology was employed, integrating a systematic literature search with qualitative thematic analysis.
  • Searches covered major databases (PubMed, CINAHL, Web of Science, Cochrane Library) and extended to organizational websites and reference lists.
  • Included studies from industrialized nations, published in English, German, or Scandinavian languages, focusing on multimorbidity and integrated care coordination.

Main Results:

  • Analysis of 47 studies revealed 'complexity' as a central theme.
  • Complexity manifests as 'case complexity' (patient's medical conditions) and 'care complexity' (organizational and professional aspects of care delivery).
  • Both patient-specific conditions and the healthcare system's organization contribute to the overall complexity of coordinating care.

Conclusions:

  • Care coordination strategies for multimorbidity should either aim to reduce complexity or embrace it.
  • Future research must explicitly address complexity in care coordination.
  • Understanding the role of healthcare professionals is crucial for developing effective new interventions for integrated care.