course ID: 1.3

Tackling the challenge of chronic illness from patient/family and health care organization perspective


Managing chronic illnesses is the health care challenge for all health care systems in high, middle and low income countries. This course addresses chronic illness management at the level of patient/family, health care provider (micro level) and health care organization (meso level). The overall goal is to learn how to re-engineer and optimize care processes towards evidence based chronic illness management in different settings varying in health care resources.

The course will make visible what chronic illness management entails at the patient/family and health care organization level. More specifically, the course will address what it means for patients and families to live with chronic conditions and provide the basic principles on how health care providers can assist patients in behavioral change to adhere to therapies and to modify behavioral risk factors. Further we aim at providing the conceptual basis for organizational change towards models of chronic illness management that also include coordination of care and inter-professional collaboration within health care organizations. We will use examples of a variety of settings differing in available health care resources as well as type of patient populations.


At the end of the course participants will:

  • Be able to critically discuss the epidemiology of chronic illness and its implications for health care delivery
  • know principles and outcomes of chronic care models/approaches at the patient/family and institutional level
  • reflect critically on patients’ and families’ involvement in re-engineering chronic care approaches
  • understand the basic principles of self-management support including psycho-social and behavioral patient assessment and intervention and know how to integrate this on a program level
  • understand inter-professional collaboration and coordination of care within the frame of chronic care management and know how to integrate such issues on a program level
  • demonstrate skills in planning improvement of the care process for a defined chronically ill population and setting


Basic knowledge in a medical or public health field. Interest providing chronic care, developing chronic care programs or policy.

Dunja Nicca


Assistant Professor at the Institute of Nursing Science, Faculty of Medicine, University of Basel and the University Hospital Basel (CH)

Lut Berben


Endocrinology, diabetes and metabolism University Hospital of Basel, (CH)