Qual Saf Health Care 13:299-305 doi:10.1136/qshc.2004.010744
  • Developing research and practice

Improving the quality of health care for chronic conditions

  1. J E Epping-Jordan1,
  2. S D Pruitt2,
  3. R Bengoa1,
  4. E H Wagner3
  1. 1World Health Organization, Geneva, Switzerland
  2. 2Kaiser Permanente, Sacramento, CA, USA
  3. 3MacColl Institute for Healthcare Innovation, Seattle, WA, USA
  1. Correspondence to:
 J Epping-Jordan
 Coordinator, Health Care for Chronic Conditions (CCH), Noncommunicable Diseases and Mental Health (NMH), World Health Organization, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland;
  • Accepted 22 May 2004


Chronic conditions are increasingly the primary concern of healthcare systems throughout the world. In response to this challenge, the World Health Organization has joined with the MacColl Institute for Healthcare Innovation to adapt the Chronic Care Model (CCM) from a global perspective. The resultant effort is the Innovative Care for Chronic Conditions (ICCC) framework which expands community and policy aspects of improving health care for chronic conditions and includes components at the micro (patient and family), meso (healthcare organisation and community), and macro (policy) levels. The framework provides a flexible but comprehensive base on which to build or redesign health systems in accordance with local resources and demands.


  • This paper presents the views of its authors and does not necessarily represent the decisions or the stated policy of the World Health Organization.