High-quality chronic care delivery improves experiences of chronically ill patients receiving care
نویسندگان
چکیده
OBJECTIVE Investigate whether high-quality chronic care delivery improved the experiences of patients. DESIGN This study had a longitudinal design. SETTING AND PARTICIPANTS We surveyed professionals and patients in 17 disease management programs targeting patients with cardiovascular diseases, chronic obstructive pulmonary disease, heart failure, stroke, comorbidity and eating disorders. MAIN OUTCOME MEASURES Patients completed questionnaires including the Patient Assessment of Chronic Illness Care (PACIC) [T1 (2010), 2637/4576 (58%); T2 (2011), 2314/4330 (53%)]. Professionals' Assessment of Chronic Illness Care (ACIC) scores [T1, 150/274 (55%); T2, 225/325 (68%)] were used as a context variable for care delivery. We used two-tailed, paired t-tests to investigate improvements in chronic illness care quality and patients' experiences with chronic care delivery. We employed multilevel analyses to investigate the predictive role of chronic care delivery quality in improving patients' experiences with care delivery. RESULTS Overall, care quality and patients' experiences with chronic illness care delivery significantly improved. PACIC scores improved significantly from 2.89 at T1 to 2.96 at T2 and ACIC-S scores improved significantly from 6.83 at T1 to 7.18 at T2. After adjusting for patients' experiences with care delivery at T1, age, educational level, marital status, gender and mental and physical quality of life, analyses showed that the quality of chronic care delivery at T1 (P < 0.001) and changes in care delivery quality (P < 0.001) predicted patients' experiences with chronic care delivery at T2. CONCLUSION This research showed that care quality and changes therein predict more positive experiences of patients with various chronic conditions over time.
منابع مشابه
Perceived quality of chronic illness care is associated with self-management: Results of a nationwide study in the Netherlands.
BACKGROUND Healthcare providers are increasingly expected to help chronically ill patients understand their own central role in managing their illness. The aim of this study was to determine whether experiencing high-quality chronic illness care and having a nurse involved in their care relate to chronically ill people's self-management. METHODS Survey data from 699 people diagnosed with chro...
متن کاملChronically ill patients’ self-management abilities to maintain overall well-being: what is needed to take the next step in the primary care setting?
BACKGROUND Although widespread problems in patient-professional interaction and insufficient support of patients' self-management abilities have been recognized, research investigating the relationships among care quality, productive interaction, and self-management abilities to maintain overall well-being is lacking. Furthermore, studies have revealed differences in these characteristics among...
متن کاملThe role of hospitals in bridging the care continuum: a systematic review of coordination of care and follow-up for adults with chronic conditions
BACKGROUND Multiple studies have investigated the outcome of integrated care programs for chronically ill patients. However, few studies have addressed the specific role hospitals can play in the downstream collaboration for chronic disease management. Our objective here is to provide a comprehensive overview of the role of the hospitals by synthesizing the advantages and disadvantages of hospi...
متن کاملA patient-centred approach to health service delivery: improving health outcomes for people with chronic illness
BACKGROUND The Wagner Model provides a framework that can help to facilitate health system transition towards a chronic care oriented model. Drawing on elements of this framework as well as health policy related to patient centred care, we describe the health needs of patients with chronic illness and compare these with services which should ideally be provided by a patient-centred health syste...
متن کاملBetter experiences with quality of care predict well-being of patients with chronic obstructive pulmonary disease in the Netherlands
OBJECTIVE This study was conducted to (1) identify improvements in care quality and well-being of patients with chronic obstructive pulmonary disease in the Netherlands and (2) investigate the longitudinal relationship between these factors. METHODS This longitudinal study was conducted among patients diagnosed with chronic obstructive pulmonary disease enrolled in the Kennemer Lucht care pro...
متن کامل