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Edward H. Wagner
Brian T. Austin
Michael Von Korff
Feb 7, 2024
Jan 31, 2024
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Usual medical care often fails to meet the needs of chronically ill patients, even in managed, integrated delivery systems. The medical literature suggests strategies to improve outcomes in these patients. Effective interventions tend to fall into one of five areas: the use of evidence-based, planned care; reorganization of practice systems and provider roles; improved patient self-management support; increased access to expertise; and greater availability of clinical information. The challenge is to organize these components into an integrated system of chronic illness care. Whether this can be done most efficiently and effectively in primary care practice rather than requiring specialized systems of care remains unanswered.
Author(s): Edward H. Wagner; Brian T. Austin; Michael Von Korff
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Volume 74, Issue 4 (pages 511–544) Published in 1996
Edward H. Wagner
Donald M. Berwick
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The Milbank Quarterly is an editorially independent multidisciplinary journal that offers in-depth assessments of the social, economic, political, historical, legal, and ethical dimensions of health and health care policy.