Managing chronic conditions: Experience in eight countries



One of the greatest challenges facing health systems in the 21st century is the need to develop effective approaches to address the growing burden of chronic disease. Chronic diseases are complex and require a long-term, multifaceted response that coordinates inputs from a wide range of health professionals, essential medicines and – where appropriate – monitoring equipment, all of which is optimally embedded within a system that promotes patient empowerment.

With many health systems still largely built around an acute, episodic model of care, health professionals, policy-makers and patient organizations struggle to respond in ways that meet the needs of people with complex chronic health problems.

This book examines the health system response to the rising burden of chronic disease in eight countries. It provides a detailed assessment of the current situation, a description of the policy framework and future scenarios, as well as evaluation and lessons learned.

It shows that many different strategies are being implemented, with different models of care at varying degrees of development, and with differing comprehensiveness. Perhaps not surprisingly, the approaches adopted often reflect the characteristics of each health system, each with its own governance mechanisms and relationships between, and responsibilities of, different stakeholders. Nonetheless, there are many lessons for those seeking to develop effective responses to this common challenge.


The editors

Ellen Nolte is a Senior Lecturer at the London School of Hygiene & Tropical Medicine, United Kingdom.

Cécile Knai is a Research Fellow at the London School of Hygiene & Tropical Medicine, United Kingdom. Martin McKee is Professor of European Public Health at the London School of Hygiene & Tropical Medicine, United Kingdom, and Head of Research Policy of the European Observatory on Health Systems and Policies.


Contributors include Carl-Ardy Dubois, Isabelle Durand-Zaleski, Daragh K Fahey, Anne Frølich, Nicholas Glasgow, Mark Harris, Iqbal Hasan, Izzat Jiwani, Tanisha Jowsey, Ingvar Karlberg, Eveline Klein Lankhorst, Cécile Knai, Allan Krasnik, Martin McKee, Ellen Nolte, Olivier Obrecht, Michaela L. Schiøtz, Ulrich Siering, Debra de Silva, Cor Spreeuwenberg and Nicholas Zwar.