- Research Article
- 10.64784/061
Reframing Complexity in Internal Medicine: Evidence-Based Strategies for Managing Multimorbidity in Latin America
- Dec 10, 2025
- IECCMEXICO
- José Enrique González Araujo + 7 more +7
Multimorbidity has become a defining challenge for internal medicine, characterized by the coexistence of multiple chronic diseases and shaped by functional decline, treatment burden, and socioeconomic vulnerability. This review synthesizes contemporary evidence on the epidemiology, clinical consequences, and health-system implications of multimorbidity, with a particular focus on Mexico, Colombia, and Ecuador. Findings demonstrate steep age-related increases in prevalence, strong associations with mortality, hospitalization, disability, and elevated costs, and significant variability driven by methodological differences and inequities in access to care. Functional impairment consistently emerges as a central predictor of adverse outcomes, underscoring the need for geriatric-informed, person-centered approaches. Despite extensive observational research, interventional and policy-oriented studies remain limited, especially in middle-income settings. The review highlights the urgent need for integrated care models, improved coordination between internal medicine and primary care, and equity-oriented policies capable of responding to the complex trajectories of multimorbidity. By integrating theoretical, epidemiological, and health-system perspectives, this study provides a foundation for advancing research, guiding clinical decision-making, and informing system reforms in Latin American internal medicine.
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