Addressing Multimorbidity to Improve Healthcare and Economic Sustainability

Abstract

Patients with multimorbidity are responsible for more than half of all healthcare utilization, challenging the healthcare budgets of all European nations. Although the European Union is showing signs of a fragile economic recovery, achieving sustainable growth will depend on delivering a combination of fiscal responsibility, structural reforms, and improved efficiency. Addressing the challenges of multimorbidity and providing more effective, affordable, and sustainable care, has climbed the political agenda at a global, European, and national level. Current healthcare systems are poorly adapted to cope with the challenges of patients with multimorbidity. Little is known about the epidemiology and natural history of multimorbidity; the evidence base is weak; clinical guidelines are not always relevant to this population; and financing and delivery systems have not evolved to adequately measure and reward quality and performance. Pockets of innovation are, however, beginning to emerge. In Spain, for example, the ongoing economic crisis has forced regional governments to deliver substantial efficiency savings and, with this in mind, integrated care programmes have been introduced across the country for people with chronic disease and multimorbidity. Early results suggest that formalized integrated care for patients with multimorbidity improves their perceptions of care coordination, reduces hospital and emergency admissions and readmissions, and reduces average costs per capita. Such innovations require meaningful investments at a national level – something that is now supported within the framework of the European Union’s Stability and Growth Pact.

Use of an Electronic Clinical Decision Support System in Primary Care to Assess Inappropriate Polypharmacy in Young Seniors With Multimorbidity: Observational, Descriptive, Cross-Sectional Study

“…In the absence of such financial strategies, the sustainability of any system reforms will be compromised. 585 Encouragingly, however, there have been some efforts across Europe to improve the care for patients with multimorbidity by using innovative financing strategies to create a stimulus to promote the coordination and integration of care. 586,587,588 One example is the provision of 'add-on payments' which are given to HCPs who achieve specific outcomes related to improved care.…”

Perceived Value of eHealth among People Living with Multimorbidity: A Qualitative Study

“…Adhering to clinical practice guidelines can have undesirable effects, such as adverse drug interactions [ 25 ]. Thus, many healthcare systems are insufficiently organized to handle multimorbidity [ 26 ], and even though multimorbidity is becoming increasingly common, the evidence base for enhancing care for people with multimorbidity is still limited [ 27 ].…”

The problem of multiple somatic and/or psychiatric pathology basic concepts and prevalence

“…На противоположную тенденцию указывают J. Sauver и соавт. [57]: пораженность вторым заболеванием выше в популяции женщин, чем мужчин (40,3 Социально-экономический статус пациентов и уровень их образования вносят существенный вклад в распространенность мультиморбидности: она встречается чаще у лиц с низким уровнем дохода, образования и социального статуса [74][75][76][77]. Ph.…”