Chronic care: a need in search of a system

Currently, the bulk of our healthcare dollars is being spent on chronic illnesses and their associated complications. Given this use of resources, it is essential to identify, develop, and implement a system of care that is unique to those with long-term health concerns. Effective management of these problems depends largely on patient participation and strategies that are appropriate for the primary delivery site, which is the home. Such concepts are foreign to most current disease-management programs, and years will be required for acceptance and implementation. Quality long-term management requires a systematic, comprehensive system of care that is unique to the needs of both patients and providers. Such a system consists of a series of integrated, interdependent components that will be presented in this article.