Multimorbidity Healthcare Delivery Models: An Approach to the Current Situation in Colombia

OBJECTIVES: Multimorbidity has been defined as the coexistence of multiple chronic diseases in the same patient. The importance of implementing care models with a focus on multimorbidity lies in the ability to address the patient's healthcare needs more effectively, given their increased risk of disability and mortality. The aim of this research was to establish a diagnosis of care from a chronicity and multimorbidity perspective within the context of the Colombian healthcare system.

METHODS: From a descriptive perspective using a quantitative questionary, eight workshops were conducted across eight cities in Colombia, encompassing a total of 63 Health Care Organizations (HCOs). Five components were assesed using the Joint Action on Chronic Diseases (JA-CHRODIS) framework: care model, decision-making, self-management, information systems and technologies, and social/community resources. For each component, the average score was utilized as the primary outcome for analysis.

RESULTS: The average scores for the five components were as follows: care model 4/8 (50%); decision making 3.2/6 (53%); self-management 4.1/6 (68%); information systems and technology 5.4/8 68%); and social/community resources 2.2/4 (55%). The aggregated score showed that HCOs score mainly ranked between 34-66% on all 5 components across all five components.

CONCLUSIONS: The diagnostic phase revealed significant variability in the performance of HCOs across the five evaluated components. The relatively low scores in the care model and social/community resources components highlight critical areas requiring targeted improvements. Strengthening these areas could lead to more comprehensive and effective management of multimorbidity. Moreover, the consistent moderate scores across components suggest a need for a concerted effort to enhance decision-making, self-management, and the integration of information systems and technology. The implementation of an integral multimorbidity model, is essential to drive progress and achieve better health outcomes in the Colombian healthcare system.