Background: Multimorbidity is a major issue for primary care. We aimed to explore primary care professionalsââ?¬â?¢\naccounts of managing multimorbidity and its impact on clinical decision making and regional health care delivery.\nMethods: Qualitative interviews with 12 General Practitioners and 4 Primary Care Nurses in New Zealandââ?¬â?¢s Otago\nregion. Thematic analysis was conducted using the constant comparative method.\nResults: Primary care professionals encountered challenges in providing care to patients with multimorbidity with\nrespect to both clinical decision making and health care delivery. Clinical decision making occurred in time-limited\nconsultations where the challenges of complexity and inadequacy of single disease guidelines were managed\nthrough the use of ââ?¬Å?satisficingââ?¬Â (care deemed satisfactory and sufficient for a given patient) and sequential\nconsultations utilising relational continuity of care. The New Zealand primary care co-payment funding model was\nseen as a barrier to the delivery of care as it discourages sequential consultations, a problem only partially\naddressed through the use of the additional capitation based funding stream of Care Plus. Fragmentation of care\nalso occurred within general practice and across the primary/secondary care interface.\nConclusions: These findings highlight specific New Zealand barriers to the delivery of primary care to patients\nliving with multimorbidity. There is a need to develop, implement and nationally evaluate a revised version of\nCare Plus that takes account of these barriers
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