Medicolegal Issues

Complex Medically Ill Patients: A Challenge for PCPs and Hospitalists


Every year, primary-care physicians (PCPs) and hospitalists struggle to manage care for complex medically ill patients, according to a new survey conducted by SHM and QuantiaMD.

Complex medically ill patients have two or more concurrent chronic conditions that require ongoing medical attention or limit activities of daily living. These 4 million patients, which make up 10% of the Medicare population, consume a disproportionate amount of acute healthcare resources, accounting for up to 20% of ED visits, and have significantly higher likelihood of hospital admission and readmission, according to the survey.1 This presents a challenge to both inpatient and outpatient providers charged with coordinating their care.

SHM, in partnership with QuantiaMD, conducted a survey of nearly 4,000 physicians about this topic, which has resulted in a white paper and online expert series to outline opportunities and feature innovative examples to improve patient care of the complex medically ill.

“Communication greatly impacts quality of care and the ability to prevent excess hospital admissions and readmissions,” says Michael Radzienda, MD, SFHM, principal investigator for the Medically Complex Ill Project. “Findings from the study identified barriers to timely and effective communication on the health team who care for the medically complex ill and opportunities to implement the latest innovations to improve patient care and safety.”

A new expert practice series in the reducing readmissions special-interest group from SHM and QuantiaMD, “Innovations in Care Coordination for the Complex Medically Ill,” grew from the study and provides best practices, and also features actual case studies of existing care-coordination efforts. This online interactive forum is the first of its kind, providing resources to address care-coordination challenges that have plagued patient care over the past decade. The series includes nine presentations on topics including patient-centered medical homes, telemedicine, and post-discharge clinics.


  1. Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009;360(14):1418-1428.

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