Caring for Patients with Multiple Chronic Conditions

The millions of Americans living with more than one chronic disease are at high risk of poor health outcomes, and account for a disproportionate share of health care costs. A special March supplement to Medical Carepresents updates from the Agency for Healthcare Research and Quality's (AHRQ) Multiple Chronic Conditions (MCC) Research Network, formed to address knowledge gaps and research challenges in meeting the complex health care needs of this growing population.  

Meeting the Needs of People with MCC—More Than Just a "Collection of Diseases"

The March special supplement, titled Advancing the Field: Results from the AHRQ Multiple Chronic Conditions Research Network, presents research and commentaries based on grants funded by AHRQ to improve understanding about how to best care for the growing number of people living with multiple chronic conditions (MCC). The AHRQ MCC Research Networksupports the U.S. Department of Health & Human Services' (HHS) Multiple Chronic Conditions Strategic Framework and the HHS Initiative on Multiple Chronic Conditions, a public-private sector partnership to address the needs of people living with MCC and the health systems that serve them.  

"This special issue presents important evidence that can help to ensure safe and high quality health care for the growing number of people who live with more than one ongoing condition," commented AHRQ Director Richard Kronick, PhD.

It is estimated that more than one-fourth of all Americans, and two-thirds of older adults, are living with MCC— defined as two or more chronic physical or behavioral health problems. Care for patients with MCC accounts for an estimated two-thirds of the nation's nearly $3 trillion in total health care spending. As the US population ages, the number of people with MCC is increasing steadily—by 2030, there are expected to be more than 170 million Americans living with at least one chronic condition.

The special issue "captures the state of research on MCC and serves as a model for future research in the field," according to an introductory editorial by Guest Editors Mary E. Tinetti, MD, of Yale University and Jayasree Basu, PhD, MBA, of AHRQ.

In their overview paper, David Grembowski, PhD and colleagues highlight the need for a new conceptual approach to MCC. They believe the focus on single conditions needs to be replaced by a model accounting for the "inherent complexity" presented by the mismatch between patients' needs and the current structure of the health care system.

Similarly, Lisa LeRoy, PhD and coauthors emphasize that caring for patients with MCC involves more than treatment of a "collection of diseases." They call for a focus on "holistic outcomes in humans who live meaningful lives in relationship with family and community."

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