Issue brief: designing integrated approaches to support people with multimorbidity in Ontario
Année de publication: 2013
Managing multiple medical conditions is part of the daily
life of a growing number of Ontarians. As Fortin et al.
observed, “patients with multiple conditions are the rule
rather than the exception in primary care.”(2)
Multimorbidity (living with three or more medical
conditions) has attracted significant attention among
health system policymakers and stakeholders in Ontario, in
part because adults with multimorbidity account for more
than two-thirds of healthcare costs.(3)
Multimorbidity not only has a significant impact on
healthcare utilization and costs, but affects quality of life,
ability to work, employability, disability, processes of care
and mortality.(4) Despite the burden of multimorbidity,
patients often receive care that is “fragmented, incomplete,
inefficient, and ineffective.”(4) Thus, there have been
growing calls for changes to health systems and clinical
decision-making processes to more effectively and
efficiently provide the complex care required by those with
multimorbidity.(5;6)
One such response in Ontario has been Health Links,
which was launched in December 2012 and now includes
26 ‘early adopters’. Health Links are designed to support
local patient-care networks, led by a coordinating partner,
and attempt to coordinate and optimize access to needed
services, initially with a particular focus on the 5% of
patients who consume about 66% of healthcare costs.(3;7)
However, primary care, community care and other
providers, whether working as part of or separate from
Health Links, need support to achieve measurable
successes in caring for patients with multimorbidity and
preventing multimorbidity in those at risk, and to achieve
health system transformation more broadly for this patient
group.