23.4 Briefing

摘要

Multi-morbidity has recently come to renewed international atten-tion due to its impact on disease susceptibility and outcomes forpeople infected with SARS-Cov-2, the agent responsible for COVID-19. People with multiple long-term conditions are usually those in thehighest 5% of health-care spenders, and their care incurs approxi-mately 60% of all health-care costs, in the United States at least. 1There, the top 10% of Medicare beneficiaries have health-care costsover 6 times those without Medicare, and incur Medicare paymentsover six times those of fee-for-service patients. 2-4 People with mul-tiple long-term conditions often feel misunderstood or ashamed andstruggle with a sense of personal disintegration. 5-7 Thus, patient in-volvement with these people is important if efforts are to be effec-tive that aim to intervene in ways that change outcomes that matterto these patients.