Organizing care for patients with chronic illness

Milbank Q. 1996;74(4):511-44.


Usual medical care often fails to meet the needs of chronically ill patients, even in managed, integrated delivery systems. The medical literature suggests strategies to improve outcomes in these patients. Effective interventions tend to fall into one of five areas: the use of evidence-based, planned care; reorganization of practice systems and provider roles; improved patient self-management support; increased access to expertise; and greater availability of clinical information. The challenge is to organize these components into an integrated system of chronic illness care. Whether this can be done most efficiently and effectively in primary care practice rather than requiring specialized systems of care remains unanswered.

Publication types

  • Review

MeSH terms

  • Chronic Disease / therapy*
  • Continuity of Patient Care
  • Disease Management
  • Humans
  • Models, Organizational*
  • Patient Education as Topic
  • Patient-Centered Care*
  • Primary Health Care / organization & administration
  • Randomized Controlled Trials as Topic
  • United States