How to improve care for people with multimorbidity in Europe?

Mieke Rijken, Verena Struckmann, Iris van der Heide, Anneli Hujala, Francesco Barbabella, Ewout van Ginneken, François Schellevis. On behalf of the ICARE4EU consortium

Where do policy makers start if they want to prepare their health systems for the growing challenge of multimorbidity? This overarching policy brief examines how to support patient-centred integrated care provision by changing clinical practice and reforming the health and social care system.  Key messages include that:

• Patients with multimorbidity are not having their needs met because Europe’s health systems are “disease oriented” and organized around single medical specialties, which fragments care.
• This “fragmentation” is associated with contradictory medical advice, inappropriate use of health services and poor patient satisfaction but it can be tackled by making care both more integrated and more patient-centred.
• Policy-makers can foster better integration and a patient centred approach (and so improve care and patient satisfaction) if they 
  • Align policy, regulatory and financial environments
  • Address professional roles, multidisciplinary work, and coordination
  • Support a range of tools to enable individualized and patient centred care, and
  • Encourage active patient and carer participation.