improvements in the functional autonomy or quality of life of chronically ill persons.

• Tabulation of the statistically significant findings of these studies and the models’ relationships to community-based services, such as whether medical and community-based services were coordinated or not.

• Internet searches for reports posted between June 1, 2008, and June 30, 2011, to obtain information about other promising models of chronic care, research about which has not yet been peer-reviewed or published in scientific journals.

From among 15 models of comprehensive care that have been shown to improve life significantly for chronically ill persons, we identified 6 that integrate medical and community-based care:

• Transitional care

• Caregiver education and support

• Chronic disease self-management

• Interdisciplinary primary care

• Care/case management

• Geriatric evaluation and management

In the future, other new models of comprehensive care may also be shown to improve functional autonomy and quality of life.

Public health initiatives that seek to improve the functional autonomy and quality of life of persons with chronic conditions should:

• Explore opportunities to collaborate with organizations that pay for (i.e., insurers) or participate in (i.e., providers) these six successful new models of comprehensive chronic care.

• Use mass media to communicate public messages to chronically ill persons, their families, their health care providers and their local community agencies about the importance of integrating medical and community-based care.

• Evaluate longitudinally the effects of collaborations between medical and community-based care providers on the functional autonomy and quality of life of Americans living with chronic conditions.


Throughout 2011, the American baby boom generation began reaching age 65. The population ages 65 and older will swell to 40 million in 2011,

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