IPCHS. Integrated People-Centred Health Services


May 26, 2016 Europe

Developing care for a changing population: Supporting patients with costly, complex needs

Patients with multiple chronic conditions are a challenge for health care organization. In this report, it is offered a review of the most recent evidence regarding new models of care, and they are summarized in 10 points: (I) There are no specific ‘European’ answers to the problem of high cost/complexity, but a growing body of policy-relevant evidence is emerging, (II) Multifaceted interventions seem to work best for complex problems , (III) Identifying who is at risk of complexity is a crucial first step , (IV) The needs of patients identified as ‘complex’ are likely to vary considerably , (V) Good outcomes for complex patients need to be rooted in patient preferences and are likely to include non-medical goals, (VI) Interventions may not reduce high costs, at least in the short term, (VII) Chronic care models may not be fit for purpose for complex patients, (VIII) Although highly relevant, the implications for the workforce are often neglected in research studies/new interventions, (IX) Designing an intervention starts by fully understanding the problem, (X) Evidence of change needs to be given adequate time and robust evaluation.


For each of these points, some studies are reviewed and analyzed in order to make current evidence easier to be understood.

Nuffield Trust