The Foundations Framework for Developing and Reporting New Models of Care for Multimorbidity.

Area of Science:

• Health systems research
• Primary care innovation
• Geriatric medicine

Background:

• Multimorbidity poses significant challenges to global health systems.
• Existing models of care for multimorbidity lack a standardized framework for design and evaluation.
• Urgent need for improved care management strategies for patients with multiple chronic conditions.

Purpose of the Study:

• To develop a framework for describing and evaluating models of care for multimorbidity.
• To identify focus areas and gaps in current multimorbidity care models.
• To analyze the evolution of multimorbidity care models over time.

Main Methods:

• Literature search to identify existing models of care for multimorbidity.
• Development of a framework based on theoretical underpinnings, target populations, and care elements.
• Application of the framework to analyze current models and their historical changes.

Main Results:

• The framework categorizes models by theoretical basis, target population, and care elements (clinical focus, organization, support).
• Identified limited theoretical grounding and uneven focus on patient groups (e.g., elderly, high users) in current models.
• Observed shifts in care elements over time, including reduced home care and increased extended appointments.

Conclusions:

• The proposed framework enhances clarity in designing and reporting multimorbidity care models.
• It aids in understanding the theoretical basis and target populations of interventions.
• The framework can help advance the evidence base for effective multimorbidity care.