Assessment of the Quality of Primary Care for the Elderly According to the Chronic Care Model

Overview

Journal Rev Lat Am Enfermagem

Specialty Nursing

Date 2018 Mar 15

PMID 29538582

Citations 7

Authors

Liliam Barbosa Silva

Sonia Maria Soares

Patricia Aparecida Barbosa Silva

Joseph Fabiano Guimaraes Santos

Livia Carvalho Viana Miranda

Raquel Melgaco Santos

Affiliations

Soon will be listed here.

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.

Citing Articles

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Patient Assessment of Chronic Illness Care (PACIC) and Its Influence on Patient Compliance With Hypertension: A Cross-Sectional Study.

Zhou C, Tan F, Lai S, Chen J, Chen C, Zhang G Inquiry. 2024; 61:469580241277445.

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References

Rick J, Rowe K, Hann M, Sibbald B, Reeves D, Roland M . Psychometric properties of the Patient Assessment Of Chronic Illness Care measure: acceptability, reliability and validity in United Kingdom patients with long-term conditions. BMC Health Serv Res. 2012; 12:293. PMC: 3526462. DOI: 10.1186/1472-6963-12-293. View

Bush K, Kivlahan D, McDonell M, Fihn S, Bradley K . The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998; 158(16):1789-95. DOI: 10.1001/archinte.158.16.1789. View

de Oliveira Duarte Y, de Andrade C, Lebrao M . [Katz Index on elderly functionality evaluation]. Rev Esc Enferm USP. 2007; 41(2):317-25. DOI: 10.1590/s0080-62342007000200021. View

Nasmith L, Kupka S, Ballem P, Creede C . Achieving care goals for people with chronic health conditions. Can Fam Physician. 2013; 59(1):11-3, 15-7. PMC: 3555640. View

Glasgow R, Wagner E, Schaefer J, Mahoney L, Reid R, Greene S . Development and validation of the Patient Assessment of Chronic Illness Care (PACIC). Med Care. 2005; 43(5):436-44. DOI: 10.1097/01.mlr.0000160375.47920.8c. View

Levesque J, Feldman D, Lemieux V, Tourigny A, Lavoie J, Tousignant P . Variations in patients' assessment of chronic illness care across organizational models of primary health care: a multilevel cohort analysis. Healthc Policy. 2013; 8(2):e108-23. PMC: 3517876. View

M Jingi A, Nansseu J, Noubiap J . Primary care physicians' practice regarding diabetes mellitus diagnosis, evaluation and management in the West region of Cameroon. BMC Endocr Disord. 2015; 15:18. PMC: 4403824. DOI: 10.1186/s12902-015-0016-3. View

Grandy S, Fox K . Change in health status (EQ-5D) over 5 years among individuals with and without type 2 diabetes mellitus in the SHIELD longitudinal study. Health Qual Life Outcomes. 2012; 10:99. PMC: 3490883. DOI: 10.1186/1477-7525-10-99. View

Wagner E . Chronic disease management: what will it take to improve care for chronic illness?. Eff Clin Pract. 1999; 1(1):2-4. View

10.

Noubiap J, M Jingi A, Veigne S, Onana A, Wawo Yonta E, Kingue S . Approach to hypertension among primary care physicians in the West Region of Cameroon: substantial room for improvement. Cardiovasc Diagn Ther. 2014; 4(5):357-64. PMC: 4221322. DOI: 10.3978/j.issn.2223-3652.2014.08.08. View

11.

Fleck M, Louzada S, Xavier M, Chachamovich E, Vieira G, Santos L . [Application of the Portuguese version of the abbreviated instrument of quality life WHOQOL-bref]. Rev Saude Publica. 2000; 34(2):178-83. DOI: 10.1590/s0034-89102000000200012. View

12.

Houle J, Beaulieu M, Lussier M, Del Grande C, Pellerin J, Authier M . Patients' experience of chronic illness care in a network of teaching settings. Can Fam Physician. 2012; 58(12):1366-73. PMC: 3520666. View

13.

Tusek-Bunc K, Petek-Ster M, Ster B, Petek D, Kersnik J . Validation of the Slovenian version of patient assessment of chronic illness care (PACIC) in patients with coronary heart disease. Coll Antropol. 2014; 38(2):437-44. View

14.

Naing N . Determination of sample size. Malays J Med Sci. 2013; 10(2):84-6. PMC: 3561892. View

15.

Casillas A, Iglesias K, Flatz A, Burnand B, Peytremann-Bridevaux I . No consistent association between processes-of-care and health-related quality of life among patients with diabetes: a missing link?. BMJ Open Diabetes Res Care. 2015; 3(1):e000042. PMC: 4298028. DOI: 10.1136/bmjdrc-2014-000042. View

16.

. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016; 388(10053):1603-1658. PMC: 5388857. DOI: 10.1016/S0140-6736(16)31460-X. View

17.

Koley M, Saha S, Ghosh S, Nag G, Kundu M, Mondal R . Patient-Assessed Chronic Illness Care (PACIC) scenario in an Indian homeopathic hospital. J Tradit Complement Med. 2016; 6(1):72-7. PMC: 4765762. DOI: 10.1016/j.jtcme.2014.11.020. View

18.

Chiu H, Hsieh H, Lin Y, Kuo S, Kao H, Yeh S . Patient assessment of diabetes care in a pay-for-performance program. Int J Qual Health Care. 2016; 28(2):183-90. DOI: 10.1093/intqhc/mzv120. View

19.

Malta D, Oliveira T, Santos M, Andrade S, da Silva M . Progress with the Strategic Action Plan for Tackling Chronic Non-Communicable Diseases in Brazil, 2011-2015. Epidemiol Serv Saude. 2016; 25(2):373-390. DOI: 10.5123/S1679-49742016000200016. View

20.

Araujo L, Gama Z, Nascimento F, Oliveira H, Azevedo W, Almeida Junior H . [Evaluation of the quality of primary health care from the perspective of the elderly]. Cien Saude Colet. 2014; 19(8):3521-32. DOI: 10.1590/1413-81232014198.21862013. View