Short and long term improvements in quality of chronic care delivery predict program sustainability

Datos Bibliográficos

ID4590788
AutoresJane M Cramm (0000-0001-5367-3207, Erasmus University Rotterdam), Anna P Nieboer (0000-0002-9676-0607, Erasmus University Rotterdam)
Año2014
Volumen101
Páginas148-154
Fecha de publicación2014-01-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaSocial Science & Medicine (JOURNAL)
Identificadores de la revistaISSN: 0277-9536 • E-ISSN: 1873-5347
EditorialElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2013.11.035
PMID24560235
OpenAlexW1996464216
IdiomaEN
Citas recibidas2
Referencias citadas37

Empirical evidence on sustainability of programs that improve the quality of care delivery over time is lacking. Therefore, this study aims to identify the predictive role of short and long term improvements in quality of chronic care delivery on program sustainability. In this longitudinal study, professionals [2010 (T0): n=218, 55% response rate; 2011 (T1): n=300, 68% response rate; 2012 (T2): n=265, 63% response rate] from 22 Dutch disease-management programs completed surveys assessing quality of care and program sustainability. Our study findings indicated that quality of chronic care delivery improved significantly in the first 2 years after implementation of the disease-management programs. At T1, overall quality, self-management support, delivery system design, and integration of chronic care components, as well as health care delivery and clinical information systems and decision support, had improved. At T2, overall quality again improved significantly, as did community linkages, delivery system design, clinical information systems, decision support and integration of chronic care components, and self-management support. Multilevel regression analysis revealed that quality of chronic care delivery at T0 (p<0.001) and quality changes in the first (p<0.001) and second (p<0.01) years predicted program sustainability. In conclusion this study showed that disease-management programs based on the chronic care model improved the quality of chronic care delivery over time and that short and long term changes in the quality of chronic care delivery predicted the sustainability of the projects

Chronic care · Chronic disease · Data mining · Decision support system · Disease · Disease management · Family medicine · Management system · Multilevel model · Operations management · Quality (philosophy · Quality management · Sustainability · Chronic Disease Management Strategies · Computer Science · Engineering · Health Policy Implementation Science · Medicine · Nursing · Primary Care and Health Outcomes · Internal Medicine