Integrated Care in Europe: New Models of Management of Chronic Patients

Background

Europe is currently facing a scene characterized by the necessity to cope several kinds of social challenges (Garcés & Monsonis-Payá, 2013); firstly, the well-known socio-demographic change, which prognosticates a notable increase of elders as a share of the global population. Thus, according to The 2012 Ageing Report (European Commission, 2012) the population aged 65 and above from the European Union will almost double, rising from 87.5 million in 2010 to around 160 million in 2060. Also, the number of older people aged 80 years and above is projected to increase by even more, almost tripling from 23.7 million in 2010 to over 65 million in 2060.

Elderly people often suffer chronic diseases or comorbidity – as diabetes, cardiovascular diseases, chronic respiratory diseases or stroke –, which entail the need of provision of LTC, with high health needs and costs (Geneau et al., 2010). According to the World Health Organization chronic conditions are by far the main cause of mortality in the world, representing 60% of all deaths (WHO, 2005); and, for example in Spain their care accounts for 70% of the healthcare expenditure (García-Goñi et al., 2012). This complex situation is worsening – in some countries more notably than in others around Europe – by the current context of austerity and fiscal policies triggered by the economic crisis (Ifanti et al., 2013). Governments and entities are searching measures aimed to assure the efficiency and sustainability of public systems, without having a negative impact on the quality of the care provision to patients.