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Health Aff (Millwood). 2009 Jan-Feb;28(1):113-25. doi: 10.1377/hlthaff.28.1.113.

The ironic business case for chronic care in the acute care setting.

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  • 1Brookdale Department of Geriatrics at Mount Sinai School of Medicine and James J. Peters VA Hospital in New York City, USA.


The U.S. health care system provides acute care tools to deal with the problems of chronic disease, and strategies are needed to engage hospitals in chronic care innovations. Acute care-based models that improve chronic care have been developed, but their diffusion is limited by the absence of a business case for adoption. Yet a financial case for improving chronic care is possible by aggregating previously tested models into a service line that can be customized to local circumstances. Beyond benefits to hospitals, patients and payers could benefit from improved patient outcomes and costs; society could benefit from more appropriate deployment of resources.

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