Publications

This paper discusses the challenges that those living with complex chronic disease present to the Canadian health-care system. The literature suggests home care and the management of complex chronic disease can together ease many of the present and future pressures facing the health-care system in dealing with this new health-care phenomenon. A review of current literature and dialogue with key informants reveals that the current level of investment and the present policy environment are not ...

OBJECTIVES: To find the social and economic characteristics, and to identify the problems and health needs, of chronic patients confined to the home (CPHs). DESIGN: A descriptive cross-sectional study. SETTING: Otxarkoaga Health Centre (Bilbao). PARTICIPANTS: 121 CPHs of the 134 identified. These included patients with sub-acute, chronic or terminal illness, with physical and/or psychological disability, and/or with lack of social or family support, which prevented their attending the Health Centre. MEASUREMENTS AND RESULTS ...

OBJECTIVES: To describe the management of the geriatric hospital home assessment team to support at primary care in the need of health of geriatric patients. DESIGN: Prospective observational study. SETTING: 5-North health district from Madrid. PARTICIPANTS AND METHODS: All patients evaluated at home and the coordination activities between primary care and hospital geriatric service, developed by the geriatric assessment team between january 1997 at december 1999. Inquiry to primary care physicians about the usefulness of ...

Patients who are seen by internists seldom have a single, well-defined nosological entity. More often they are elderly patients with marginal pluripathology who have associated chronic or terminal illness with their attendant social problems. Nowadays, the majority of patients with the most prevalent diseases fit this profile. Sometimes, in large hospitals, the Department of Internal Medicine has little opportunity to manage specific or defined entities without the 'competition' of other subspecialist colleagues. Until a consensus ...

AIM: To determine the influence of the cognitive state on the presence of different frailty factors in the elderly. METHODS: Study of an outpatient elderly population with chronic diseases (resident at home or institutionalised), the presence of different frailty risk factors and their relation to cognitive state (measured using the mini-mental state examination-MEC). RESULTS: Study of 147 elderly people with an average age of 71.4 years and a similar proportion of men (74; 50 ...

OBJECTIVE: To compare the concept of patient with pluripathology (PP) with the index of comorbidity of Charlson (IC) respect to the resources use and prognosis of hospitalized patients. PATIENTS AND METHODS: An observational prospective study of 207 consecutively hospitalized patients in an internal medicine unit was conducted. The PP, a variant of PP with three or more criteria (PP3), IC and IC fit to the age (ICE) were determined, and their relation with the consumption ...

The purpose of the study was to identify, validate and rank, through multi-attribute hierarchical analysis, indicators of quality of care related to the empowerment of patients having a chronic complex illness, or their natural care givers.

The book achieved its original overarching objective: to act as a powerful stimulus for collective effort, across traditional boundaries, among people interested in improving the management of complex chronic diseases. Without the incentive associated with the creation of something so tangible, or the pressure generated by publication deadlines and launch dates, it would have been difficult to achieve so much, in so short a period of time, and with no financial incentives.

Chronic conditions and diseases are the leading cause of mortality and morbidity in Europe, accounting for 86% of total premature deaths, and research suggests that complex conditions such as diabetes and depression will impose an even greater health burden in the future – and not only for the rich and elderly in high-income countries, but increasingly for the poor as well as low- and middle-income countries. The epidemiologic and economic analyses in the first part ...

Primary care and care for chronic cancer patients in Europe: position paper of the European Forum for Primary Care.