Table 3.

Chronicity Prevention and Care Programme (PPAC) criteria.

COMPLEXITY CRITERIA	ANSWER
Patient-dependent criteria (PPAC)
Multimorbidity (≥2 chronic diseases)	Yes/No/Don’t know
A single severe chronic disease (including advanced frailty states)	Yes/No/Don’t know
A chronic progressive disease	Yes/No/Don’t know
High probability of undergoing decompensations with many symptoms and poor control	Yes/No/Don’t know
Patient with very dynamic evolution, variable, who needs continuous follow-up	Yes/No/Don’t know
High utilization of health services (emergency, Primary care appointments)	Yes/No/Don’t know
Polypharmacy (≥ 5 medicines) and/or high cost of resources	Yes/No/Don’t know
Frail patients with functional loss, probability of acute deterioration (functional or cognitive) or new onset of geriatric syndromes	Yes/No/Don’t know
Professional Dependent criteria (PPAC)
Need for multidisciplinary hospital management	Yes/No/Don’t know
Need to activate and manage access to different resources (often by preferred routes)	Yes/No/Don’t know
Environment of special uncertainty in the decisions and doubts in clinical management	Yes/No/Don’t know
Social complexity
Patient with adverse psychosocial situations (PPAC)	Yes/No/Don’t know
Patient whose management would benefit from integrated care strategies (PPAC)	Yes/No/Don’t know
Patient with relational problems	Yes/No/Don’t know
Patient with economic problems	Yes/No/Don’t know
Patient with loss of functional autonomy	Yes/No/Don’t know
Other criteria
Patient with chronic neurological disease	Yes/No/Don’t know
Patient with severe mental disorder	Yes/No/Don’t know
Patient with dementia	Yes/No/Don’t know
Patient with psychic disability	Yes/No/Don’t know
Elderly patient (≥75 years old)	Yes/No/Don’t know