title: Co-ordination and management of chronic conditions in Europe: the role of primary care--position paper of the European Forum for Primary Care.
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.
authors.affiliation: Health Services Research and Health Economics, Department of Health Sciences, University of Applied Sciences, Fulda, Germany. stefan.gress@hs-fulda.de
authors.forename: Stefan
authors.initials: S
authors.lastname: Gress
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Baan
authors.forename: Michael
authors.initials: M
authors.lastname: Calnan
authors.forename: Toni
authors.initials: T
authors.lastname: Dedeu
authors.forename: Peter
authors.initials: P
authors.lastname: Groenewegen
authors.forename: Helen
authors.initials: H
authors.lastname: Howson
authors.forename: Luc
authors.initials: L
authors.lastname: Maroy
authors.forename: Ellen
authors.initials: E
authors.lastname: Nolte
authors.forename: Marcus
authors.initials: M
authors.lastname: Redaèlli
authors.forename: Osmo
authors.initials: O
authors.lastname: Saarelma
authors.forename: Norbert
authors.initials: N
authors.lastname: Schmacke
authors.forename: Klaus
authors.initials: K
authors.lastname: Schumacher
authors.forename: Evert Jan
authors.initials: EJ
authors.lastname: van Lente
authors.forename: Bert
authors.initials: B
authors.lastname: Vrijhoef
mesh_terms: D002908:Chronic Disease / Q000628:therapy*; D003695:Delivery of Health Care / Q000458:organization & administration*; D005060:Europe; D006801:Humans; D019451:Information Management / Q000458:organization & administration; D007391:International Cooperation; D017146:Models, Organizational; D011320:Primary Health Care / Q000379:methods* / Q000458:organization & administration*; D012648:Self Care