Our health care system is not providing optimal care for those with multiple long term health issues.
Multimorbidity is common in New Zealand, with one in four New Zealanders living with multiple long-term health conditions. They are among the highest users of the health-care system, with long-term conditions making up 80% of primary care presentations. Anna Askerud, a Principal Lecturer in Nursing, and her University of Otago collaborators recently reviewed the challenge of caring for New Zealanders reporting multimorbidity.
Most primary care General Practices continue to operate with 15 minute consultations designed to address acute presentations. The system is reactive and biomedically focussed, dispensing advice and treatment regimes for single conditions. Previous attempts to improve care for multimorbidity, with a new model of care and/or additional funding, have largely been ineffective because of the constraints of the primary care business model.
What is needed instead is a proactive approach that is patient-focused and integrates strategies using internationally recognised chronic care principles. An interprofessional health care team should take account of the whole person and enhance self-management for people living with multimorbidity. A consistent nationwide approach is needed to deliver cultural and systemic change to the provision of health care for improved care of New Zealanders living with long term health conditions.
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