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Care of Complex Chronic Conditions
Chronic health conditions, with attendant increased risk of disability, functional limitations, and complex self-management needs, as well as high health care spending, affect ever greater numbers of veterans. We have an expanding evidence base about provider care and interventions as well as knowledge about "how and why" both individual health care providers and health care delivery systems use, standardize, and apply evidence. What is yet to be developed, however, is a body of evidence about health care delivery to, and experiences of health and disease among, patients with multiple, complex chronic conditions. VA has strong primary care and a comprehensive set of chronic care services, yet optimal care relies on a patient or caregiver's ability to negotiate a multitude of providers, ancillary services and administrative tasks. Further, despite improvements in clinical care, veterans with chronic conditions receive care in many VA and non-VA settings, creating problems in coordination and continuity of care. For these patients and their caregivers, clinical decision making and required care processes are neither routine nor standard; complicated regimens, interactions of different diseases, and the cumulative effect of different conditions on morbidity, mortality and quality of life offer new challenges, and the need for evidence applies equally across patient-focused, provider-focused, and system-focused domains. Chronic conditions are broadly defined to include physical illnesses or impairments, with or without co-morbid, chronic mental illness or impairment, that have persistent or recurring health consequences lasting for years and which may contribute to increased risk of early mortality. Care of complex, chronic conditions is an HSR&D priority as described in the current Program Announcement of HSR&D Priorities.
For general information about the Care of Complex Chronic Conditions, please contact:
Katherine Bent, RN, PhD, CNS
Associate Chief Nurse
Health Services Research and Development (124N)
Email: katherine.bent@va.gov
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