scholarly journals Willingness of patients with chronic disease in rural China to contract with family doctors: implication for targeting characteristics

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jie Li ◽  
Jie Li ◽  
Peipei Fu ◽  
Yan Chen ◽  
Xue Tang ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Chronic Conditions ◽  
Chronic Disease Management ◽  
Family Doctor ◽  
Chronic Patients ◽  
Rural Residents ◽  
Cross Sectional ◽  
Family Doctors ◽  
The Government

Abstract Background Rural residents with chronic conditions have a stronger need for health services, which should make using family doctor contract services a priority. This study aimed to evaluate the rate of willingness among rural residents with chronic conditions to contract with family doctors and examine its determinants. Methods A cross-sectional study was conducted from May, 2018 to June, 2018 in Shandong Province in China. A total of 769 rural unsigned residents with chronic conditions were included in the analysis. Using the Andersen model as the theoretical framework, logistic regression models were chosen to analyse the factors associated with willingness to contract with family doctors. Results This study found that the rate of willingness to contract with family doctors among chronic patients in rural Shandong was 46.7%. A higher willingness was observed in those living a further distance from the village clinic (more than 600 m: OR = 1.85, 95%CI =1.17–2.93), having received publicity for family doctor contract services (OR = 1.71, 95% CI = 1.06–2.76), reporting need for utilizing a chronic disease management program (OR = 3.36, 95% CI = 2.20–5.23), and reporting need for higher medical insurance reimbursement (OR = 1.91, 95% CI = 1.28–2.83). Conclusions The prevalence of contract willingness was relatively low among unsigned rural residents with chronic conditions in rural Shandong, China. The need factors were powerful factors affecting their willingness to contract with family doctors. The government should therefore strengthen targeted publicity and education to rural residents with chronic conditions and provide targeted healthcare services, such as chronic disease management programs and medical services with higher reimbursement rates, to promote their willingness to contract with family doctors.

Self-management factors associated with quality of life among women with endometriosis: a cross-sectional Australian survey

2020 ◽  
Author(s):  
Rebecca O’Hara ◽  
Heather Rowe ◽  
Jane Fisher
Keyword(s):  
Quality Of Life ◽  
Chronic Disease ◽  
Disease Management ◽  
Self Efficacy ◽  
Chronic Disease Management ◽  
Self Management ◽  
Cross Sectional ◽  
Female Population ◽  
Management Factors

Abstract STUDY QUESTION What self-management factors are associated with quality of life among women with endometriosis? SUMMARY ANSWER Greater self-efficacy was associated with improved physical and mental quality of life. WHAT IS KNOWN ALREADY Women with endometriosis have an impaired quality of life compared to the general female population. However, most studies have investigated quality of life in a hospital or clinic setting rather than a community setting and the association between self-management factors and quality of life have not, to date, been investigated. STUDY DESIGN, SIZE, DURATION A cross-sectional, population-based online survey was performed, which was advertised through women’s, community and endometriosis-specific groups. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 620 women completed the survey for this study. Mental and physical quality of life was assessed using the standardized SF36v2 questionnaire. Self-management factors included self-efficacy, partners in health (active involvement in managing the condition) and performance of self-care activities. Treatment approaches included the use of hormonal treatment, pain medications and complementary therapies and whether the participant had a chronic disease management plan. Hierarchical regression analyses were used to examine whether self-management and treatment factors were associated with quality of life. MAIN RESULTS AND THE ROLE OF CHANCE Both physical and mental quality of life were significantly lower among women with endometriosis compared to the mean scores of the general Australian female population (P < 0.001). Physical quality of life was positively associated with income sufficiency (P < 0.001) and greater self-efficacy (P < 0.001), but negatively associated with age (P < 0.001), pain severity (P < 0.001), use of prescription medications (P < 0.001), having a chronic disease management plan (P < 0.05) and number of self-care activities (P < 0.05). Mental quality of life was positively associated with being older (P < 0.001), partnered (P < 0.001), having a university education (P < 0.05), increasing self-efficacy (P < 0.001) and higher partners in health scores (P < 0.001). LIMITATIONS, REASONS FOR CAUTION Results are derived from a cross-sectional study and can only be interpreted as associations not as causal relationships. The sample was more educated, more likely to speak English and be born in Australia than the general Australian female population of the same age, which may influence the generalizability of these results. WIDER IMPLICATIONS OF THE FINDINGS This study investigated a knowledge gap by investigating quality of life of women with endometriosis in a large community sample. Self-efficacy was significantly associated with both physical and mental quality of life. Supporting women with endometriosis to improve self-efficacy through a structured chronic disease management programme may lead to improvements in this aspect of wellbeing. STUDY FUNDING/COMPETING INTEREST(S) R.O. undertook this research as part of her PhD at Monash University, which was supported by an Australian Government Research Training Program Stipend. J.F. is the Finkel Professor of Global Public Health, which was supported by the Finkel Family Foundation. There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER NA.

scholarly journals Use of the Nursing Outcomes Classification - NOC to assess the knowledge of patients with venous ulcer

2020 ◽  
Vol 41 (spe) ◽  
Author(s):  
Viviane Maria Osmarin ◽  
Fernanda Guarilha Boni ◽  
Taline Bavaresco ◽  
Amália de Fátima Lucena ◽  
Isabel Cristina Echer
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Chronic Disease Management ◽  
Management Strategies ◽  
Venous Ulcer ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Nursing Outcomes ◽  
Treatment And Prevention ◽  
Nursing Outcomes Classification

Abstract Objective: To evaluate the knowledge of patients with venous ulcers (VU) on their chronic disease, treatment, and prevention of complications, according to the Nursing Outcomes Classification-NOC. Methods: This is a cross-sectional study conducted between 2017 and 2018 in a Brazilian hospital. The sample consisted of 38 patients with VU attended in outpatient nursing consultations. The study analyzed sociodemographic, clinical and nine indexes from the Knowledge: Chronic Disease Management (1847) of the NOC, assessed using a five-point Likert scale, analyzed using descriptive statistics. Results: The mean of the result Knowledge: Chronic Disease Management (1847) was 3.56±1.42. The clinical index Procedures involved in treatment regimen had the highest mean 4.18±0.21, followed by Pain management strategies with 3.92±0.27. In the association between knowledge and healing, the best scores were in patients with at least one healed VU. Conclusion: The knowledge of the patients was moderate and it was necessary to promote educational actions according to individual demands.

scholarly journals Can voucher scheme enhance primary care provision for older adults: cross-sectional study in Hong Kong

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Johnny T. K. Cheung ◽  
Samuel Y.S. Wong ◽  
Dicken C. C. Chan ◽  
Dexing Zhang ◽  
Lawrence H. F. Luk ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Hong Kong ◽  
Chronic Disease ◽  
Disease Management ◽  
Continuity Of Care ◽  
Chronic Disease Management ◽  
Outpatient Clinics ◽  
Cross Sectional ◽  
The Public

Abstract Background The Hong Kong government has launched the Elderly Health Care Voucher (EHCV) scheme to facilitate primary care in the private sector for older adults. This study aimed to examine whether voucher use was associated with a shift of healthcare burden from the public to the private sector, vaccine uptake and continuity of care. Methods This cross-sectional survey recruited older adults with ≥3 chronic diseases through convenience sampling from seven general outpatient clinics, seven geriatric day hospitals, and five specialist outpatient clinics of the public healthcare sector in Hong Kong. We used multiple logistic regression to address the study objective. Results A total of 1032 patients participated in the survey. We included 714 participants aged 70 or above in the analysis. EHCV use was associated with higher utilization of private primary care services, including general practitioner and family doctor (Adjusted Odds Ratio (AOR) 2.67, 95% Confidence Interval (95%CI) 1.51–4.72) and Chinese medicine clinic (AOR 3.53, 95%CI 1.47–8.49). There were no significant associations of EHCV use with public general outpatient clinic attendance, Accident & Emergency attendance, and hospitalization. Furthermore, EHCV users were more likely to receive pneumococcal vaccination (AOR 2.17, 95%CI 1.22–3.85) and were less likely to visit the same doctors for chronic disease management (AOR 0.10, 95%CI 0.01–0.73). Conclusions While the EHCV may promote private primary care utilization and preventive care, older patients continue to rely on public services and the EHCV may worsen continuity of care. Policy-makers should designate voucher usage for chronic disease management and continuity of care.

scholarly journals Perceived facilitators and barriers to chronic disease management in primary care networks: a qualitative study

2020 ◽  
Author(s):  
Chuan De Foo ◽  
Shilpa Surendran ◽  
Chen Hee Tam ◽  
Elaine Qiao Ying Ho ◽  
David Bruce Matchar ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Disease Management ◽  
Qualitative Study ◽  
Chronic Disease Management ◽  
Primary Care Providers ◽  
Great Promise ◽  
Ageing Population ◽  
Chronic Patients ◽  
Facilitators And Barriers

Abstract Background The increasing chronic disease burden in developed countries has placed tremendous strain on tertiary healthcare infrastructure and resources. Therefore, there is an urgent need to shift chronic disease management from tertiary to primary care providers to mitigate the increase in demand for chronic care at hospitals. The organization of private general practitioners (GPs) into Primary Care Networks (PCNs) is a pragmatic move by Singapore, a developed and multi-ethnic urban city, to provide private GPs with team-based care capabilities and a platform to track care indicators for better management of chronic patients. As the PCN initiative is still in its embryonic stages, there is a void in research regarding its ability to empower private GPs to manage chronic patients effectively. This qualitative study aims to explore the facilitators and barriers for the management of chronic patients by private GPs in the PCN. Method: We conducted 30 semi-structured in-depth interviews with GPs enrolled in a PCN. Qualitative analysis of audio transcripts was performed to extract themes which highlighted the facilitators and barriers faced by PCN in the early stages of its development. Results Our results suggest that PCNs facilitated private GPs to more effectively manage chronic patients through 1) provision of ancillary services such as diabetic foot screening, diabetic retinal photography and nurse counselling to permit a “one-stop-shop”, 2) systematic monitoring of process and clinical outcome indicators through a chronic disease registry (CDR) to promote accountability for patients’ health outcomes and 3) funding streams for PCNs to hire additional manpower to oversee operations and to reimburse GPs for extended consultations. Barriers include high administrative load in maintaining the CDR due to the lack of a smart electronic clinic management system and financial gradient faced by patients seeking services from private GPs which incur higher out-of-pocket expenses than public primary healthcare institutions. Conclusion PCNs demonstrate great promise in empowering and motivating private GPs to manage chronic patients. However, barriers will need to be addressed to ensure the quality and comprehensiveness of PCNs in managing more chronic patients in the face of an ageing population.

scholarly journals Perceived facilitators and barriers to chronic disease management in primary care networks: a qualitative study

2020 ◽  
Author(s):  
Chuan De Foo ◽  
Shilpa Surendran ◽  
Chen Hee Tam ◽  
Elaine Qiao Ying Ho ◽  
David Bruce Matchar ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Disease Management ◽  
Qualitative Study ◽  
Chronic Disease Management ◽  
Primary Care Providers ◽  
Great Promise ◽  
Ageing Population ◽  
Chronic Patients ◽  
Facilitators And Barriers

Abstract Background: The increasing chronic disease burden in developed countries has placed tremendous strain on tertiary healthcare infrastructure and resources. Therefore, there is an urgent need to shift chronic disease management from tertiary to primary care providers to mitigate the increase in demand for chronic care at hospitals. The organization of private general practitioners (GPs) into Primary Care Networks (PCNs) is a pragmatic move by Singapore, a developed and multi-ethnic urban city, to provide private GPs with team-based care capabilities and a platform to track care indicators for better management of chronic patients. As the PCN initiative is still in its embryonic stages, there is a void in research regarding its ability to empower private GPs to manage chronic patients effectively. This qualitative study aims to explore the facilitators and barriers for the management of chronic patients by private GPs in the PCN. Method: We conducted 30 semi-structured in-depth interviews with GPs enrolled in a PCN. Qualitative analysis of audio transcripts was performed to generate themes which highlighted the facilitators and barriers faced by PCN in the early stages of its development. Results: Our results suggest that PCNs facilitated private GPs to more effectively manage chronic patients through 1) provision of ancillary services such as diabetic foot screening, diabetic retinal photography and nurse counselling to permit a “one-stop-shop”, 2) systematic monitoring of process and clinical outcome indicators through a chronic disease registry (CDR) to promote accountability for patients’ health outcomes and 3) funding streams for PCNs to hire additional manpower to oversee operations and to reimburse GPs for extended consultations. Barriers include high administrative load in maintaining the CDR due to the lack of a smart electronic clinic management system and financial gradient faced by patients seeking services from private GPs which incur higher out-of-pocket expenses than public primary healthcare institutions.Conclusion: PCNs demonstrate great promise in empowering and motivating private GPs to manage chronic patients. However, barriers will need to be addressed to ensure the quality and comprehensiveness of PCNs in managing more chronic patients in the face of an ageing population.

scholarly journals Chronic Disease Management Programs Based On Caring Theory With Blood Pressure Reduction

2021 ◽  
Vol 5 (1) ◽  
pp. 70-76
Author(s):  
Apriyani Puji Hastuti ◽  
Ardhiles Wahyu Kurniawan ◽  
Hanim Mufarokhah
Keyword(s):  
Blood Pressure ◽  
Chronic Disease ◽  
Disease Management ◽  
Diastolic Blood Pressure ◽  
Chronic Disease Management ◽  
Blood Pressure Reduction ◽  
Management Program ◽  
Pressure Reduction ◽  
Cross Sectional ◽  
Disease Management Programs

Background: Hypertension cases to overcome the patient's hypertension condition would be well or prosperous condition and the patient could prevent complications and control blood pressure. Activities in Chronic Disease Management Program (Prolanis) include medical or educational consultations, home visits, reminders, club activities.Purpose: This study aimed to analyze the application of the prolanis program based on the caring theory by reducing blood pressure in hypertensive patients.Methods: The design of this research is pre-experimental with cross sectional study approach. The population in this study were all patients with hypertension who took part in management program activities in the public health center (PHC), a number of 40 people, with the sampling technique used was accidental sampling and the total sample was 28 people. The data collection method used a questionnaire. The data analysis of this research is to use the Paired t test.Results: The result of this study is that there is a relationship between the application of a chronis disease management programs based on caring theory with blood pressure reduction with an average systolic blood pressure before the intervention of 142?26.15 and after the intervention of 138?1.21 with p= 0.000 which means that the module intervention can decrease systolic and diastolic blood pressure. While for diastolic blood pressure, the results of the study showed that the mean blood pressure before the intervention was 85?10.36 and after the intervention was 85?7.61 with p= 0.000.Conclusion: It can be concluded that there is a possitive effect between giving prolanis module based on caring theory with systolic and diastolic blood pressure

scholarly journals Can voucher scheme enhance primary care provision for older adults: cross-sectional study in Hong Kong

2020 ◽  
Author(s):  
Johnny Cheung ◽  
Samuel Y.S. Wong ◽  
Dicken C. C. Chan ◽  
Dexing Zhang ◽  
Lawrence H.F. Luk ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Hong Kong ◽  
Chronic Disease ◽  
Disease Management ◽  
Continuity Of Care ◽  
Chronic Disease Management ◽  
Outpatient Clinics ◽  
Cross Sectional ◽  
The Public

Abstract Background The Hong Kong government has launched the Elderly Health Care Voucher (EHCV) scheme to facilitate primary care in the private sector for older adults. This study aimed to examine whether voucher use was associated with a shift of healthcare burden from the public to the private sector, vaccine uptake and continuity of care.Methods This cross-sectional survey recruited older adults with ≥3 chronic diseases through convenience sampling from seven general outpatient clinics, seven geriatric day hospitals, and five specialist outpatient clinics of the public healthcare sector in Hong Kong. We used multiple logistic regression to address the study objective.Results A total of 1032 patients participated in the survey. We included 714 participants aged 70 or above in the analysis. EHCV use was associated with higher utilization of private primary care services, including general practitioner and family doctor (Adjusted Odds Ratio (AOR) 2.67, 95% Confidence Interval (95%CI) 1.51–4.72) and Chinese medicine clinic (AOR 3.53, 95%CI 1.47–8.49). There were no significant associations of EHCV use with public general outpatient clinic attendance, Accident & Emergency attendance, and hospitalization. Furthermore, EHCV users were more likely to receive pneumococcal vaccination (AOR 2.17, 95%CI 1.22–3.85) and were less likely to visit the same doctors for chronic disease management (AOR 0.10, 95%CI 0.01–0.73).Conclusions While the EHCV may promote private primary care utilization and preventive care, older patients continue to rely on public services and the EHCV may worsen continuity of care. Policy-makers should designate voucher usage for chronic disease management and continuity of care.

scholarly journals Chronic disease management: Discussing the perspectives of general practitioners in Italy

2019 ◽  
Vol 33 (1) ◽  
pp. 13-23
Author(s):  
Sara Barsanti ◽  
Francesca Guarneri
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
General Practitioners ◽  
Chronic Care Model ◽  
Chronic Care ◽  
Chronic Disease Management ◽  
Point Of View ◽  
Care Model ◽  
Chronic Patients ◽  
Bonferroni Test

The aim of this paper is to provide an overview of general practitioners’ perspectives across key criteria for effective chronic disease management. The study setting is the Tuscany Region in Italy that implemented the Chronic Care Model in 2010 with multidisciplinary team to assist chronic patients. We used the results of a web-based survey of general practitioners (N = 1136) conducted in 2015 to compare the experiences and satisfaction of general practitioners involved (group 1) and not involved (group 2) in the Chronic Care Model. The analysis included all general practitioners, and compared the two groups’ perspectives of the different core aspects of Chronic Care Model through conducting an ANOVA analysis and Bonferroni test. General practitioners involved in the Chronic Care Model are found to be more favourably disposed toward measurement and benchmarking, and more satisfied in terms of decision support system. Conversely, no significant differences were found in terms of collaboration with specialists, which remains weak and in terms of community collaboration and involvement. This study provides a detailed investigation of the implementation of Disease Management Programs, by considering the professional point of view.

HUBUNGAN KEIKUTSERTAAN SENAM PROLANIS DENGAN KETERKONTROLAN TEKANAN DARAH PADA PASIEN BPJS DI KLINIK BATAM SEHAT

2020 ◽  
Vol 9 (2) ◽  
pp. 17-25
Author(s):  
Andi Ipaljri Saputra ◽  
Isramilda ,
Keyword(s):  
Blood Pressure ◽  
Chronic Disease ◽  
Disease Management ◽  
Disease Management Program ◽  
Chronic Disease Management ◽  
Statistical Tests ◽  
Management Program ◽  
P Value ◽  
Cross Sectional ◽  
Uncontrolled Blood Pressure

Since 2014 BPJS Health has implemented the Chronic Disease Management Program (PROLANIS) which has a program of medical/educational consultation activities, home visits, reminders, club activities such as gymnastics and health status monitoring with the target of all BPJS health participants with chronic diseases (Diabetes Mellitus) Type 2 and Hypertension). The Batam Sehat Clinic conducted a chronic disease management program in 2015 with 154 registered patients, while BPJS patients who took part in the PROLANIS exercise in July-September 2018 totaled 155 people. This type of research is an observational analytic survey with a cross-sectional approach conducted at Batam Sehat Clinic. Data obtained by taking medical records in the form of attendance PROLANIS gymnastics with a total sampling technique that the overall number of BPJS patients who take PROLANIS exercises from July-September is 155 BPJS patients. From 155 BPJS patients, the frequency distribution of BPJS patients participating in PROLANIS and blood pressure was controlled 71 (85.5%) and uncontrolled blood pressure was 12 (14.5%). While those who did not participate in PROLANIS exercise were controlled blood pressure 32 (44.4%) and 40 (55.6%) uncontrolled blood pressure. Based on the results of statistical tests it is known that there is a correlation between the participation of PROLANIS gymnastics and blood pressure control in BPJS patients in Batam Sehat Clinic with p-value = 0,000 where p <0.05. Based on this research, it can be concluded that there is a correlation between the participation of PROLANIS gymnastics and the control of blood pressure in BPJS patients.

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