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Innovating care for people with multiple chronic conditions in Europe

Lupe [1]


At the moment the total number of people with multiple chronic conditions in the European population is estimated at about 50 million and this number is expected to even further increase. This poses a great challenge to health systems and the delivery of healthcare and social services, as not only will the number of chronically ill people increase, their needs for care will also increase and become more complex because of ageing and multimorbidity. Innovation of chronic illness care is urgently needed as current care delivery models are not adapted to the needs of the growing number of people with multiple chronic health problems. Moreover, innovation is necessary to provide good quality care with limited resources. New models and integrated care programmes for (older) people with multiple chronic conditions are now being developed and implemented. In most European countries an overview and analysis of patient-centered multisectoral and multidisciplinary care programmes that address people with (multiple) chronic conditions is lacking. Since an actual overview of European integrated care programmes addressing multimorbidity is not available yet, ICARE4EU aims to provide such an overview of programmes and initiatives. This includes the analysis of their characteristics, strengths and weaknesses, and ensuring regular updates, is an important step to enhance the quality and sustainability of multimorbidity chronic illness care in Europe.


The Project

ICARE4EU will describe and analyze approaches addressing the needs for health and social care provided by multidisciplinary teams for people with multiple chronic conditions that are developed or implemented in 30 European countries. It aims to contribute on disseminating knowledge and innovative solutions to improve chronic illness care in Europe.

ICARE4EU activities focus on:

  • description of the state of the art of integrated care models
  • evaluation of their strengths and weaknesses from four different perspectives: patient-centredness, management practices and professional competencies, use of e-health technology  and financing systems
  • identification & analysis of innovative best practice solutions for people with multiple chronic conditions
  • design of a template for future evaluation of the developments in multimorbidity chronic illness care
  • identification of key characteristics for successful management & implementation strategies
  • promotion of knowledge transfer to successfully implement multimorbidity chronic care between stakeholders and policy-makers in Europe
  • dissemination of findings throughout Europe, also beyond a scientific scope.


ICARE4EU  Work Packages:

Coordination of the project
Dissemination of the project
Evaluation of the project
Data collection and state of the art in 30 European countries
Patient- centeredness of integrated care programmes addressing multimorbidity in Europe
Management & professional competencies in integrated care programmes addressing multimorbidity in Europe
Use of e-health technologies in integrated care for older people with multiple chronic conditions in Europe
Financing of integrated care for people with multiple chronic conditions in Europe

As the leader of the work packages 2 and 8, the department of Health Care Management focuses mainly on dissemination of the project and financing of integrated care for people with multiple chronic conditions in Europe.  The dissemination strategy includes a promotional flyer, a policy brief, a monitoring template and the organization of an international symposium.  The overall aim is to inform the public and stakeholders concerning the aim and outline of the project and to provide policy options.


Coordinator:      NIVEL (Netherlands Institute for Health Services Research)

Contact:             PO box 1568; 3500 BNUTRECHT

The Netherlands

Tel.: 00 +31 302729700

Associated partners:

  • Technical University Berlin, Germany
  • University of Eastern Finland, Finland 
  • University of Warwick, United Kingdom
  • National Institute of Health and Science on Aging, Italy

Collaborating partners:

  • AGE Platform Europe (AGE)
  • Eurocarers
  • European Observatory on Health Systems and Policies (OBS) (supportive institution)

Website: www.icare4eu.org [2]

Flyer: Have a look at the project flyer here [3]

Project News:

January 22, 2014 | BMJ Blog  Read the BMJ blog [4]

April 14, 2014 | IFIC presentation Have a look here [5]

April 28, 2014 | BMJ Blog  Read the BMJ blog [6]

June 4, 2014 | Newsletter  Read the newsletter [7]

July 9, 2014 | First Results The first results of the ICARE4EU programmes in the form of four Country Factsheets are available. These factsheets provide information on multimorbidity programmes and the policy context in Finland [8], Germany [9], Italy [10] and the Netherlands [11].

August 5, 2015 | BMJ Blog  Read the BMJ blog [12]

Case Reports

The Case Reports provide information on innovative examples of multimorbidity programmes which were selected from our database. The presented cases were reviewed in depth during site visits that occurred in the first half of 2015.

  • Case report PROTOCOL 3 Programme Belgium [13]
  • Case report Clinic Silkeborg [14]
  • Case report Valencia [15]
  • Case report POTKU Finland [16]
  • Case report Gesundes Kinzigtal Germany [17]
  • Case report INCA Model [18]
  • Case report TeleRehabilitation programme [19]
  • Case report Diabetic Care Burgas programme [20]

State-of-the-art report

The State-of-the-Art report provides an overview of innovative programmes and approaches in Europe to address the challenges of care provision to people with multimorbidity. Information will be provided on various characteristics of integrated care programmes for people with multimorbidity that have been identified in 31 European countries.

  • ICARE4EU State-of-the-Art report [21], Appendix C [22]

Verena Struckmann
+49 30 314 29045
Sekretariat H80
Room H8180
e-mail query [23]

Ewout van Ginneken
+49 30 314 29483
Sekretariat H80
Room H8111
e-mail query [24]
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