title: Issues concerning the on-going care of patients with comorbidities in acute care and post-discharge in Australia: a literature review.
abstract: BACKGROUND
  Advances in medical science and improved lifestyles have reduced mortality rates in Australia and most western countries. This has resulted in an ageing population with a concomitant growth in the number of people who are living with chronic illnesses. Indeed a significant number of younger people experience more than one chronic illness. Large numbers of these may require repeated admissions to hospital for acute or episodic care that is superimposed upon the needs of their chronic conditions.
  
  
  OBJECTIVE
  To explore the issues that circumscribe the complexities of caring for people with concurrent chronic illnesses, or comorbidities, in the acute care setting and postdischarge.
  
  
  METHODS
  A literature review to examine the issues that impact upon the provision of comprehensive care to patients with comorbidities in the acute care setting and postdischarge.
  
  
  RESULTS
  Few studies have investigated this subject. From an Australian perspective, it is evident that the structure of the current health care environment has made it difficult to meet the needs of patients with comorbidities in the acute care setting and postdischarge. This is of major concern for nurses attempting to provide comprehensive care to an increasingly prevalent group of chronically ill people.
  
  
  CONCLUSIONS
  Further research is necessary to explore how episodic care is integrated into the on-going management of patients with comorbidities and how nurse clinicians can better use an episode of acute illness as an opportunity to review their overall management.
mesh_terms: D000208:Acute Disease / Q000191:economics / Q000453:epidemiology* / Q000451:nursing*; D000359:Aftercare; D001315:Australia; D002908:Chronic Disease / Q000191:economics / Q000453:epidemiology / Q000451:nursing; D015897:Comorbidity; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007902:Length of Stay; D010359:Patient Readmission; D017060:Patient Satisfaction; D011787:Quality of Health Care / Q000191:economics