Improving Quality of Care for Diabetes Through a Maintenance of Certification Activity: Family Physiciansʼ Use of the Chronic Care Model

2014 ◽  
Vol 34 (1) ◽  
pp. 47-55 ◽  
Author(s):  
Lars E. Peterson ◽  
Brenna Blackburn ◽  
Robert L. Phillips ◽  
James C. Puffer
Author(s):  
Líliam Barbosa Silva ◽  
Sônia Maria Soares ◽  
Patrícia Aparecida Barbosa Silva ◽  
Joseph Fabiano Guimarães Santos ◽  
Lívia Carvalho Viana Miranda ◽  
...  

ABSTRACT Objective: to evaluate the quality of care provided to older people with diabetes mellitus and/or hypertension in the Primary Health Care (PHC) according to the Chronic Care Model (CCM) and identify associations with care outcomes. Method: cross-sectional study involving 105 older people with diabetes mellitus and/or hypertension. The Patient Assessment of Chronic Illness Care (PACIC) questionnaire was used to evaluate the quality of care. The total score was compared with care outcomes that included biochemical parameters, body mass index, pressure levels and quality of life. Data analysis was based on descriptive statistics and multiple logistic regression. Results: there was a predominance of females and a median age of 72 years. The median PACIC score was 1.55 (IQ 1.30-2.20). Among the PACIC dimensions, the “delivery system design/decision support” was the one that presented the best result. There was no statistical difference between the medians of the overall PACIC score and individual care outcomes. However, when the quality of life and health satisfaction were simultaneously evaluated, a statistical difference between the medians was observed. Conclusion: the low PACIC scores found indicate that chronic care according to the CCM in the PHC seems still to fall short of its assumptions.


2010 ◽  
Vol 5 (1) ◽  
pp. 71-90 ◽  
Author(s):  
Chris Ham

AbstractThe purpose of this paper is to describe the characteristics of the high-performing chronic care system and the four implementation strategies needed to achieve such a system. The paper starts with a description of the Chronic Care Model and summarises evidence on its impact. This is followed by a review of international evidence on gaps in the quality of chronic care. These gaps suggest that, useful and influential as the Chronic Care Model is, more is needed to help health care decision makers bring about the reorientation required to meet the needs of populations in which chronic diseases predominate. The second half of the paper therefore sets out the ten characteristics and four implementation strategies required to achieve a high-performing chronic care system. In doing so, it provides practical guidance to policy makers and health care leaders on the most promising strategies for improving the provision of chronic care, drawing on evidence from the experience of England, New Zealand and USA.


2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Jing-Xia Kong ◽  
Lin Zhu ◽  
Hong-Mei Wang ◽  
Ying Li ◽  
An-Ying Guo ◽  
...  

Objective. The Chronic Care Model, based on core elements of team-centered care in chronic diseases, has widely been accepted. This study was aimed at evaluating the effectiveness of the Chronic Care Model in type 2 diabetes management. Methods. A group randomized experimental study was conducted. Twelve communities of the Zhaohui Community Health Service Center in Hangzhou, China, were randomly assigned into an intervention group (n=6) receiving the Chronic Care Model-based intervention and a control group (n=6) receiving conventional care. A total of three hundred patients, twenty-five for each community, aged ≥18 years with type 2 diabetes for at least 1-year duration, were recruited. Data of health behaviors, clinical outcomes, and health-related quality of life (Short-Form 36-item questionnaire) were collected before and after a 9-month intervention and analyzed using descriptive statistics, t-test, chi-square test, binary logistic regression, and linear mixed regression. A total of 258 patients (134 in intervention and 124 in control) who completed the baseline and follow-up evaluations and the entire intervention were included in the final analyses. Results. Health behaviors such as drinking habit (OR=0.07, 95% CI: 0.01, 0.75), physical activity (OR=2.92, 95% CI: 1.18, 7.25), and diet habit (OR=4.30, 95% CI: 1.49, 12.43) were improved. The intervention group had a remarkable reduction in glycated hemoglobin (from 7.17% to 6.60%, P<0.001). The quality of life score changes of the role limitation due to physical problems (mean=9.97, 95% CI: 3.33, 16.60), social functioning (mean=6.50, 95% CI: 2.37, 10.64), role limitation due to emotional problems (mean=8.06, 95% CI: 2.15, 13.96), and physical component summary score (mean=3.31, 95% CI: 1.22, 5.39) were improved in the intervention group compared to the control group. Conclusion. The Chronic Care Model-based intervention helped improve some health behaviors, clinical outcomes, and quality of life of type 2 diabetes patients in China in a short term.


2008 ◽  
Vol 35 (5) ◽  
pp. S398-S406 ◽  
Author(s):  
Dorothy Y. Hung ◽  
Russell E. Glasgow ◽  
L. Miriam Dickinson ◽  
Desireé B. Froshaug ◽  
Douglas H. Fernald ◽  
...  

2021 ◽  
Vol 33 ◽  
pp. 141-145
Author(s):  
Luigi Apuzzo ◽  
Maddalena Iodice ◽  
Margherita Gambella ◽  
Angelica Scarpa ◽  
Francesco Burrai

In recent years, the incidence rate of chronic diseases shows a steady increase in every industrialized Country. The almost logarithmic trend of the number of people living with chronic diseases is constantly on the rise. Each predictive statistical model indicates a strong impact for national health systems at the level of the organization of care and management costs. It is urgent to systematically introduce an evidence-based care model in chronic care management such as the Chronic Care Model. The Chronic Care Model is the reference model for WHO. The Chronic Care Model allows for personalized, holistic, multi-professional assistance, characterized by a strong humanization of care, by preventive interventions and relationships between healthcare professionals, patients and caregivers as a system of care and assistance. The fundamental roles are social integration and the improvement of the quality of life of patients. The Chronic Care Model involves the use of a computerized system of information flow and telemedicine and trained healthcare professionals. The Chronic Care Model showed an improvement in the quality of life, a reduction in the number of hospitalizations, a better adherence to therapies, and a reduction in costs.


Author(s):  
Shaun Lee ◽  
Faridah Aryani ◽  
Siew Siang Chua ◽  
Li Ching Kok ◽  
Benny Efendie ◽  
...  

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