Journal of General Internal Medicine

, Volume 16, Issue 5, pp 315–319

“Serious and complex illness” in quality improvement and policy reform for end-of-life care

Health Policy

DOI: 10.1046/j.1525-1497.2001.90901.x

Cite this article as:
Lynn, J. & Forlini, J.H. J GEN INTERN MED (2001) 16: 315. doi:10.1046/j.1525-1497.2001.90901.x


Americans are living longer — a mark of success in public health and medical care — but more will live the last few years with progressive illness and disability. The dominant conception of care delivery separates “aggressive” or life-extending care from “palliative” or death-accepting care, with an assumed “transition” between them. The physiology and the experience of this population are mismatched in this model. Here, we propose a more useful category for public policy and clinical quality improvement: persons who will die as a result of “serious and complex illness.” Delivery system changes could ensure reliable, continuous, and competent care to this population.

Key Words

health policyserious and complex illness

Copyright information

© Blackwell Science Inc 2001

Authors and Affiliations

  1. 1.From the RAND Center to Improve Care of the DyingArlington
  2. 2.Senate Special Committee on Aging Minority OfficeWashington, DC
  3. 3.RAND Center to Improve Care of the DyingArlington