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BMJ 2004;328 (24 January), doi:10.1136/bmj.328.7433.0-c
National service frameworks aim to improve the management of selected chronic diseases, but a general model is still not available in the NHS. On page 220 Lewis and Dixon analyse what it takes to manage chronic diseases, and argue for a generic model that can be applied to patients with multiple conditions or with single conditions that are not yet included in the national service framework. They describe the importance of community resources, health system organisation, self management, design of medical practice, decision support, and clinical information systems within the general context of chronic disease management. They say that such a generic model is particularly important for ensuring that gains in elective care are not at the expense of progress in chronic care.
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