Department of Epidemiology and Biostatistics, National School of Public Health and REDISSEC. Carlos III Institute of Health, 28029 Madrid, Spain.
National Centre of Epidemiology and CIBERNED. Carlos III Institute of Health, 28029 Madrid, Spain.
Int J Environ Res Public Health. 2019 Dec 17;16(24):5151. doi: 10.3390/ijerph16245151.
The Integrated Multimorbidity Care Model (IMCM), developed by the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS), proposes a set of 16 multidimensional components (i.e., recommendations) to improve the care of persons with multimorbidity in Europe. This study aimed at analyzing the potential applicability of the IMCM. We followed a qualitative approach that comprised two phases: (1) The design of a case study based on empirical clinical data, which consisted of a hypothetical woman with multimorbidity, type 2 diabetes mellitus, mental health, and associated social problems, and (2) the creation of a consensus group to gather the opinions of a multidisciplinary group of experts and consider the potential applicability of the IMCM to our case study. Experts described how care should be delivered to this patient according to each model component, suggested the use of specific rating scales and tools to assess her needs in a comprehensive and regular way, and pointed our crucial health and social resources to improve her care process. Experts also highlighted patient-centered, integrated and tailored care as one of the keystones of quality healthcare. Our results suggest that the IMCM is applicable in complex patients with multimorbidity.
一体化多病种护理模式(IMCM)由慢性病联合行动(JA-CHRODIS)开发,提出了一组 16 个多维组件(即建议),以改善欧洲多病种患者的护理。本研究旨在分析 IMCM 的潜在适用性。我们采用了一种定性方法,包括两个阶段:(1)基于经验临床数据设计案例研究,该研究包括一位患有多种疾病、2 型糖尿病、心理健康和相关社会问题的假设女性;(2)创建一个共识小组,收集多学科专家小组的意见,并考虑 IMCM 对我们案例研究的潜在适用性。专家们根据每个模型组件描述了应如何为该患者提供护理,建议使用特定的评分量表和工具,以全面和定期的方式评估她的需求,并指出改善她护理过程的关键卫生和社会资源。专家们还强调了以患者为中心、综合和量身定制的护理是优质医疗保健的关键之一。我们的结果表明,IMCM 适用于患有多种疾病的复杂患者。