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Health Care for Older Americans with Multiple Chronic Conditions: A Research Agenda

Authors

  • Susan L. Norris MD, MPH,

    1. From the *Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OregonDepartment of Internal Medicine, Wake Forest University, Winston-Salem, North CarolinaDepartment of Epidemiology and Investigative Medicine, School of Medicine, Yale University, New Haven, Connecticut§Center for Clinical Epidemiology and Biostatistics, School of Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaDivision of General Internal Medicine, University of Colorado at Denver Health Sciences Center, Denver, Colorado#Division of Geriatrics, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California**Department of Psychiatry and Behavioral Sciences, University of Washington Medical Center, Seattle, Washington††Division of Geriatrics, University of California at San Francisco, San Francisco, California‡‡Geriatrics and Extended Care, San Francisco Veterans Affairs Medical Center, San Francisco, California.
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  • Kevin High MD,

    1. From the *Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OregonDepartment of Internal Medicine, Wake Forest University, Winston-Salem, North CarolinaDepartment of Epidemiology and Investigative Medicine, School of Medicine, Yale University, New Haven, Connecticut§Center for Clinical Epidemiology and Biostatistics, School of Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaDivision of General Internal Medicine, University of Colorado at Denver Health Sciences Center, Denver, Colorado#Division of Geriatrics, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California**Department of Psychiatry and Behavioral Sciences, University of Washington Medical Center, Seattle, Washington††Division of Geriatrics, University of California at San Francisco, San Francisco, California‡‡Geriatrics and Extended Care, San Francisco Veterans Affairs Medical Center, San Francisco, California.
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  • Thomas M. Gill MD,

    1. From the *Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OregonDepartment of Internal Medicine, Wake Forest University, Winston-Salem, North CarolinaDepartment of Epidemiology and Investigative Medicine, School of Medicine, Yale University, New Haven, Connecticut§Center for Clinical Epidemiology and Biostatistics, School of Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaDivision of General Internal Medicine, University of Colorado at Denver Health Sciences Center, Denver, Colorado#Division of Geriatrics, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California**Department of Psychiatry and Behavioral Sciences, University of Washington Medical Center, Seattle, Washington††Division of Geriatrics, University of California at San Francisco, San Francisco, California‡‡Geriatrics and Extended Care, San Francisco Veterans Affairs Medical Center, San Francisco, California.
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  • Sean Hennessy PharmD, PhD,

    1. From the *Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OregonDepartment of Internal Medicine, Wake Forest University, Winston-Salem, North CarolinaDepartment of Epidemiology and Investigative Medicine, School of Medicine, Yale University, New Haven, Connecticut§Center for Clinical Epidemiology and Biostatistics, School of Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaDivision of General Internal Medicine, University of Colorado at Denver Health Sciences Center, Denver, Colorado#Division of Geriatrics, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California**Department of Psychiatry and Behavioral Sciences, University of Washington Medical Center, Seattle, Washington††Division of Geriatrics, University of California at San Francisco, San Francisco, California‡‡Geriatrics and Extended Care, San Francisco Veterans Affairs Medical Center, San Francisco, California.
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  • Jean S. Kutner MD, MSPH,

    1. From the *Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OregonDepartment of Internal Medicine, Wake Forest University, Winston-Salem, North CarolinaDepartment of Epidemiology and Investigative Medicine, School of Medicine, Yale University, New Haven, Connecticut§Center for Clinical Epidemiology and Biostatistics, School of Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaDivision of General Internal Medicine, University of Colorado at Denver Health Sciences Center, Denver, Colorado#Division of Geriatrics, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California**Department of Psychiatry and Behavioral Sciences, University of Washington Medical Center, Seattle, Washington††Division of Geriatrics, University of California at San Francisco, San Francisco, California‡‡Geriatrics and Extended Care, San Francisco Veterans Affairs Medical Center, San Francisco, California.
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  • David B. Reuben MD,

    1. From the *Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OregonDepartment of Internal Medicine, Wake Forest University, Winston-Salem, North CarolinaDepartment of Epidemiology and Investigative Medicine, School of Medicine, Yale University, New Haven, Connecticut§Center for Clinical Epidemiology and Biostatistics, School of Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaDivision of General Internal Medicine, University of Colorado at Denver Health Sciences Center, Denver, Colorado#Division of Geriatrics, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California**Department of Psychiatry and Behavioral Sciences, University of Washington Medical Center, Seattle, Washington††Division of Geriatrics, University of California at San Francisco, San Francisco, California‡‡Geriatrics and Extended Care, San Francisco Veterans Affairs Medical Center, San Francisco, California.
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  • Jürgen Unützer MD, MA, MPH,

    1. From the *Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OregonDepartment of Internal Medicine, Wake Forest University, Winston-Salem, North CarolinaDepartment of Epidemiology and Investigative Medicine, School of Medicine, Yale University, New Haven, Connecticut§Center for Clinical Epidemiology and Biostatistics, School of Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaDivision of General Internal Medicine, University of Colorado at Denver Health Sciences Center, Denver, Colorado#Division of Geriatrics, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California**Department of Psychiatry and Behavioral Sciences, University of Washington Medical Center, Seattle, Washington††Division of Geriatrics, University of California at San Francisco, San Francisco, California‡‡Geriatrics and Extended Care, San Francisco Veterans Affairs Medical Center, San Francisco, California.
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  • C. Seth Landefeld MD

    1. From the *Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OregonDepartment of Internal Medicine, Wake Forest University, Winston-Salem, North CarolinaDepartment of Epidemiology and Investigative Medicine, School of Medicine, Yale University, New Haven, Connecticut§Center for Clinical Epidemiology and Biostatistics, School of Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaDivision of General Internal Medicine, University of Colorado at Denver Health Sciences Center, Denver, Colorado#Division of Geriatrics, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California**Department of Psychiatry and Behavioral Sciences, University of Washington Medical Center, Seattle, Washington††Division of Geriatrics, University of California at San Francisco, San Francisco, California‡‡Geriatrics and Extended Care, San Francisco Veterans Affairs Medical Center, San Francisco, California.
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Address correspondence to Susan L. Norris, MD, MPH, Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mail Stop B1CC, Portland, OR 97239. E-mail: norriss@ohsu.edu

Abstract

In response to the substantial and increasing healthcare requirements of older adults with multiple chronic conditions and acknowledgment of major gaps in knowledge and funding, two expert meetings were convened to identify a research agenda addressing the needs of this population. Research priorities are to develop and evaluate more-effective models of health care, develop and evaluate management practices and organizational structures that lead to improved long-term care, develop and implement relevant and effective preventive health strategies, determine the most effective interventions in patients who have concurrent cognitive or emotional impairments, and determine how interventions during and after hospitalization affect the outcomes of hospitalized patients.

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