RESEARCH Changes in costs and effe

Chronic diseases pose an increasing threat to population health, enlarge the burden of care giving, and constrain the financial viability of health care systems worldwide. Because these health care systems originate largely from an era where acute and infectious diseases were more prominent, their design is not optimal for chronic care [1]. This triggered many new approaches for providing continuous, integrated, pro-active and patient-centred care by a multidisciplinary team of care providers in order to improve health outcomes and reduce costs. There is evidence that these approaches improve the quality of the care as measured by process indicators like coordination of care, communication between caregivers, patient satisfac-tion, provider adherence to guidelines, and patient adher-ence to treatment recommendations [2]. However, there i