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Public Health Rep. 2011 Jul-Aug;126(4):460-71.

Managing multiple chronic conditions: a strategic framework for improving health outcomes and quality of life.

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U.S. Department of Health and Human Serivices, Office of the Assistant Secretary for Health, 200 Independence Ave. SW, Washington, DC 20201, USA.


The escalating problem of multiple chronic conditions (MCC) among Americans is now a major public health and medical challenge, associated with suboptimal health outcomes and rising health-care expenses. Despite this problem's growth, the delivery of health services has continued to employ outmoded "siloed" approaches that focus on individual chronic diseases. We describe an action-oriented framework--developed by the U.S. Department of Health and Human Services with additional input provided by stakeholder organizations--that outlines national strategies for maximizing care coordination and for improving health and quality of life for individuals with MCC. We note how the framework's potential can be optimized through some of the provisions of the new Patient Protection and Affordable Care Act, and through public-private partnerships.

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