La sfida della cronicità. Quale organizzazione delle cure è necessaria?

The incidence of chronic diseases has grown significantly in the last decades in western countries because of two, opposite, reasons: because medical science increased its ability to extend lives even for those patients with severe or incurable illness, and because of the risky and unhealthy lifestyles. Moreover the growing size of the elder population contributes to increase, physiologically, the number of chronic patients. In front of the increasing numbers of people with chronic conditions those health care systems that were designed to deliver acute care become uneconomical and unable to meet these patients complex needs. Therefore new models designed to guide the reorganization of the health care system arise: this paper describes some of these organizational models and the cultural change required to health care workers and patients when moving from an acute, reactive care model to a proactive care one.