Persons with multiple chronic conditions are a large and growing segment of the US population. However, little is known about
how chronic conditions cluster, and the ramifications of having specific combinations of chronic conditions. Clinical guidelines
and disease management programs focus on single conditions, and clinical research often excludes persons with multiple chronic
conditions. Understanding how conditions in combination impact the burden of disease and the costs and quality of care received
is critical to improving care for the 1 in 5 Americans with multiple chronic conditions. This Medline review of publications
examining somatic chronic conditions co-occurring with 1 or more additional specific chronic illness between January 2000
and March 2007 summarizes the state of our understanding of the prevalence and health challenges of multiple chronic conditions
and the implications for quality, care management, and costs.
KEY WORDS chronic disease - comorbidity - prevalence - quality of health care
The authors are members of the Consortium on Complex Chronic Illness, Quality, and Equity. The Consortium, directed by Dr.
A. Shields, is a collaboration of investigators from Harvard, MGH, Northwestern, the VA, Thomson Healthcare, and Ingenix committed
to accelerating research on complex chronic illness and its implications for quality and the health of vulnerable populations.