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Organizing care for patients with chronic illness
E H Wagner1, B T Austin, M Von Korff
1Group Health Cooperative of Puget Sound, Seattle, USA.
The Milbank Quarterly
|January 1, 1996
Summary
Improving care for chronically ill patients requires integrated strategies. Key interventions include evidence-based care, system reorganization, self-management support, expert access, and better information availability.
Area of Science:
- Healthcare Management
- Chronic Illness Care
- Health Services Research
Background:
- Usual medical care frequently inadequately addresses the needs of patients with chronic illnesses.
- Even within integrated delivery systems, gaps in care persist for this population.
Purpose of the Study:
- To identify and synthesize effective strategies for improving outcomes in chronically ill patients.
- To explore the integration of these strategies into a cohesive system of care.
Main Methods:
- Literature review of effective interventions for chronic illness management.
- Analysis of strategies focusing on planned care, practice reorganization, self-management support, access to expertise, and clinical information availability.
Main Results:
- Five key areas for effective interventions were identified: evidence-based planned care, practice system and role reorganization, patient self-management support, enhanced access to expertise, and improved clinical information availability.
- The primary challenge lies in integrating these components into a unified chronic illness care system.
Conclusions:
- Integrating evidence-based interventions is crucial for enhancing chronic illness care.
- Further research is needed to determine the optimal setting (primary care vs. specialized systems) for implementing integrated chronic illness management.