Prof. Sabina Nuti, Director of Management and Health Laboratory, MeS, ass. Prof at Sant’Anna School in Pisa, Italy | Ms. Daniela Scaramuccia, Tuscany Health Directorate, Italy | Prof. Gavino Maciocco at University of Firenze, Public Health department, Florence, Italy
Improving Primary Care for Patient with Chronic Illness: Tuscan experience
Medical science advances and improved living standards have saved lives and contributed to longer life expectancy, yet industrialized nations now face the growing challenge of caring for patients with chronic diseases. Health systems initially designed to respond to acute, episodic illness increasingly care for patients with ongoing conditions, where the goals include preventing complications or deterioration rather than cure. Often coping with multiple conditions, chronically ill patients may see multiple clinicians at different care sites, increasing the risks of errors and poor care coordination. Across industrialized nations, chronically ill patients account for a disproportionate share of national health spending, placing them at the center of initiatives to improve health system performance.
Considering the epidemiologic trends involving Tuscany Region, which reflect those ongoing in the rest of Italy and in most high-income countries, and moving from the intention to align the Region’s interventions on this matter to the best international experiences in management of chronic diseases, the policy makers have chosen to enhance primary care by mean of a strongly patient centered approach with a specific reference to the Chronic Care Model (CCM), defined by Mac-Coll Institute for Healthcare Innovation. Tuscany Region has recently started a project to test this model, where providers are represented by team of general practitioners, nurses and other health workers who take care of targeted populations, i.e. people with chronic conditions as diabetes type II and chronic hearth failure.