Management of complex chronic disease: facing the challenges in the Canadian health-care system

Health Serv Manage Res. 2008 Nov;21(4):228-35. doi: 10.1258/hsmr.2008.008001.


This paper discusses the challenges that those living with complex chronic disease present to the Canadian health-care system. The literature suggests home care and the management of complex chronic disease can together ease many of the present and future pressures facing the health-care system in dealing with this new health-care phenomenon. A review of current literature and dialogue with key informants reveals that the current level of investment and the present policy environment are not sustainable to support the health-care system. In this paper, changes to policy and resource allocation to the home care sector are suggested to help manage complex chronic disease and thus improve the effectiveness of the Canadian health-care system. A case is made for a reorganization and increased commitment to the home care sector for a more efficient and patient-centred health-care delivery system.

MeSH terms

  • Canada
  • Chronic Disease / therapy*
  • Health Care Reform
  • Home Care Services / organization & administration
  • Humans
  • Models, Theoretical
  • National Health Programs*
  • Organizational Innovation
  • Patient Care Team
  • Patient-Centered Care