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Peter A. Boling, MD

JAMA. 1999;281:656-657.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

After establishing a legacy of success through the ascendancy of acute care and biomedical interventions during the past half century, medicine is entering an era of chronic disease management. As the United States now grapples with the burgeoning needs of an aging society and upwardly spiralling health care costs, new strategies for organizing health care are essential. In this issue of THE JOURNAL, Naylor and colleagues¹ present findings from a randomized trial that demonstrates the effectiveness of 1 such strategy.

Within any population, a small subset of patients incurs most of the episodes of serious illness and generates a large fraction of total medical costs.^2-4 Also, patients who are hospitalized once are more likely to have readmissions, although it is difficult to predict which specific patients will be involved.^5-9 These concepts are particularly germane in geriatrics because the higher prevalence of serious chronic illness drives more . . . [Full Text of this Article]

Author Affiliation: Division of General Medicine, Virginia Commonwealth University, Medical College of Virginia, Richmond.

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