Towards coordination and tailoring of hospital care for patients with multimorbidity

Patients with multimorbidity (two or more chronic conditions) often receive fragmented hospital care, organized around separate medical specialties and focused on single diseases. Without coordination and tailoring of care, fragmented hospital care can lead to adverse outcomes. In this thesis, Verhoeff explored which strategies can contribute to improved coordination and tailoring of hospital care when multiple medical specialties are involved, in order to ensure good quality and experience of hospital care for patients with multimorbidity. First, Verhoeff explored the current Dutch hospital care for multimorbidity. These studies showed that maintaining an overview can be complex and that care professionals experience barriers for tailoring and coordinating care. Next, she developed and tried out an intervention for hospital care coordination. She learned that it is important to show the results of coordination and tailoring, and that patient selection should be refined. Her other studies illustrated how hospitals could use their own electronic health record (EHR) data to find patients who benefit most from coordination and tailoring of care.A shared vision and efforts throughout the entire healthcare system are necessary to improve coordination and tailoring of hospital care. Verhoeff recommends introducing a multimorbidity care perspective in hospitals, and organization and innovation of collaboration between care professionals in case of multimorbidity. It is important to acknowledge that coordination and tailoring of care are extra tasks that need prioritization, organization, and financing. In the future, hospitals offer tailored and coordinated hospital care for patients with multimorbidity, that benefits both patients and healthcare professionals