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Designing a high-performance health care system for patients with complex needs: ten recommendations for policymakers : expanded and revised edition
Designing a high-performance health care system for patients with complex needs: ten recommendations for policymakers : expanded and revised edition
Health care costs are heavily concentrated among people with multiple health problems. Often, these are older adults living with frailty, advanced illness, or other complex conditions. In 2014, the New York-based Commonwealth Fund, a private, independent foundation, established the International Experts Working Group on Patients with Complex Needs through a grant to the London School of Economics and Political Science. The group's purpose was to outline the prerequisites of a high-performing health care system for "high-need, high-cost" patients and to identify promising international innovations in health care delivery for meeting needs of these patients. Drawing on international experience, quantitative and qualitative evidence, and its members' collective expertise in policy and program design, implementation, and evaluation, the international working group sought to articulate the principles that underpin high performance for this complex population in health systems around the world. What follows are the group's top recommendations based on these principles. All 10 present challenges, with some requiring profound paradigm shifts--for instance, away from disease-specific care delivery and toward more patient-centered approaches, or away from the single-provider model and toward cooperation and teamwork. Their implementation, however, has the potential to transform care and quality of life for millions. The selected international models that follow the recommendations represent some of the promising frontline care innovations that illustrate the principles laid out here.
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