How should health policy respond to the growing challenge of multimorbidity?
We need patient-centred care, with more emphasis on generalist rather than specialist care and better integration between general practice, hospitals and social care
Authors: Chris Salisbury, Bruce Guthrie, Dundee); Peter Bower and Stewart W Mercer
There is growing awareness internationally of the increasing number of people living with multiple long-term health condition, known as multimorbidity. Health services, including the NHS, need to adapt to address this challenge.
People with multimorbidity are more likely to experience poor quality of life and poor physical and mental health. They use both general practice and hospital services far more than often than the general population. Treatment itself can be an additional burden if they need to take numerous prescribed drugs and attend frequent health care appointments.
More and more people are living with multimorbidity. A major driver of this is that people are living longer. Multimorbidity poses major challenges for health care systems around the world, which are largely designed to manage individual diseases and episodes of illness. These need to be re-orientated towards providing care for people who have several long-standing health conditions at the same time, many of which are manageable but not curable.
There will need to be a new relationship between patients and health care professionals, which will engage patients more in managing their health conditions themselves. Health care services need to invest in better generalist care and become less focussed on care for single diseases, and closer integration of health and social care will be necessary.