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