Co-ordination and management of chronic conditions in Europe: the role of primary care - position paper of the European Forum for Primary Care
Authors: Greß, Stefan1; Baan, Caroline A.2; Calnan, Michael3; Dedeu, Toni4; Groenewegen, Peter5; Howson, Helen6; Maroy, Luc7; Nolte, Ellen8; Redaèlli, Marcus9; Saarelma, Osmo10; Schmacke, Norbert11; Schumacher, Klaus12; van Lente, Evert Jan13; Vrijhoef, Bert14
Source: Quality in Primary Care, Volume 17, Number 1, February 2009 , pp. 75-86(12)
Publisher: Radcliffe Publishing Ltd.
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Abstract:
Healthcare systems in Europe struggle with inadequate co-ordination of care for people with chronic conditions. Moreover, there is a considerable evidence gap in the treatment of chronic conditions, lack of self-management, variation in quality of care, lack of preventive care, increasing costs for chronic care, and inefficient use of resources. In order to overcome these problems, several approaches to improve the management and co-ordination of chronic conditions have been developed in European healthcare systems. These approaches endeavour to improve self-management support for patients, develop clinical information systems and change the organisation of health care. Changes in the delivery system design and the development of decision support systems are less common. Almost as a rule, the link between healthcare services and community resources and policies is missing. Most importantly, the integration between the six components of the chronic care model remains an important challenge for the future. We find that the position of primary care in healthcare systems is an important factor for the development and implementation of new approaches to manage and coordinate chronic conditions. Our analysis supports the notion that countries with a strong primary care system tend to develop more comprehensive models to manage and co-ordinate chronic conditions.Keywords: CHRONIC CARE MODEL; DISEASE MANAGEMENT; INTERNATIONAL COMPARISON; PRIMARY CARE
Document Type: Research article
Affiliations: 1: Health Services Research and Health Economics, Department of Health Sciences, University of Applied Sciences, Fulda, Germany 2: National Institute for Public Health and the Enviroment, Centre for Prevention and Health Services Research, Bilthoven, The Netherlands 3: Professor of Medical Sociology, University of Kent, UK 4: International Office, Spanish Society of Family and Community Medicine, Barcelona, Spain 5: Director of NIVEL; Professor of Social and Geographical Aspects of Health and Healthcare, Utrecht University, The Netherlands 6: Senior Health Strategy Advisor; Head of Community Health Strategy and Development, Welsh Assembly Government, UK 7: Advisor NIHDI; Affiliated Junior Researcher KU, Leuven, Belgium 8: London School of Hygiene & Tropical Medicine, UK 9: Health Economist; Institute of General Practice and Family Medicine, University of Witten-Herdecke, Germany 10: Health Center of Espoo, Finland 11: Professor of Public Health; Director of the Working and Coordination Group Health Services Research, University of Bremen, Germany 12: IMTG, Austria 13: Director Care Management, AOK-Social Health Insurance, Federal Association, Germany 14: Care and Public Health Research Institute and Director Research, Department of Integrated Care, Maastricht University Medical Centre, The Netherlands
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