The July 20, 2021 session of Duke Medicine LEADS featured David Ming, MD, presenting, "Systems of Care for Patients with Complex Health Needs: It’s Complicated."
Here are pearls and takeaways from the session:
- Adults with multiple chronic conditions (MCC) are defined as adults with 2+ chronic conditions that result in limitations in ADLs and require regular medical care.
- Adults with MCC are a growing population that contribute the most to medical expenditures, with the top 5% of patients accounting for 50% of all costs in 2017.
- Better health for complex patients is about more than medical care, and strong care coordination requires a focus on the "interstitial space," the time in-between interactions with the healthcare system.
- Complex Care Programs are models that utilize interdisciplinary care teams to ensure care coordination in the "interstitial space", address the intersection of sociocultural needs with the delivery of healthcare, and proactively prevent fragmentation of care.
- Trials evaluating Complex Care Programs are emerging; the implementation of Duke Children's Complex Care Service (CCS) resulted in a significant improvement in hospital length of stay.
Duke Medicine Learning, Education, and Discussion Series (LEADS) takes place each Tuesday at 12 p.m. Learn more and see schedule of upcoming sessions.
