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Individual care plans for chronically ill patients within primary care in the Netherlands: Dissemination and associations with patient characteristics and patient-perceived quality of care.

Jansen DL, Heijmans M, Rijken M - Scand J Prim Health Care (2015)

Bottom Line: Patients with a low educational level and patients with poor(er) self-rated health were more likely to have an ICP.Compared with patients without an ICP, patients with an ICP more often reported that the care they received was patient-centred, proactive, planned, and included collaborative goal setting, problem-solving, and follow-up support.More research is needed to gain insight into the effectiveness of ICPs to improve the quality of chronic illness care in various patient populations.

View Article: PubMed Central - PubMed

Affiliation: NIVEL, Netherlands Institute for Health Services Research , Utrecht , The Netherlands.

ABSTRACT

Objective: To examine the use of individual care plans (ICPs) within primary chronic illness care in the Netherlands, and to explore the relationships between ICP use, patient characteristics, and patient-perceived quality of care.

Design: Cross-sectional study using survey data from a panel of chronically ill patients and medical registration data provided by their general practices.

Setting and subjects: A sample of 1377 patients with somatic chronic disease(s) randomly selected in general practices throughout the Netherlands, supplemented with a sample of 225 COPD patients, also recruited from general practices.

Main outcome measures: (i) Percentage of ICP use based on self-report by chronically ill patients, and (ii) patient-perceived quality of care as assessed using the Patient Assessment of Chronic Illness Care (PACIC).

Results: ICP use among the total generic sample was low (9%), but slightly higher (13%) among patients diagnosed with diabetes or COPD, diseases for which disease management programmes have been set up in the Netherlands. Patients with a low educational level and patients with poor(er) self-rated health were more likely to have an ICP. Compared with patients without an ICP, patients with an ICP more often reported that the care they received was patient-centred, proactive, planned, and included collaborative goal setting, problem-solving, and follow-up support.

Conclusion and implications: Findings reveal a discrepancy between practice and policy aspirations regarding ICP use in primary chronic illness care. More research is needed to gain insight into the effectiveness of ICPs to improve the quality of chronic illness care in various patient populations.

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Flowchart study sample.
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Figure 1: Flowchart study sample.

Mentions: In April 2011, the panel consisted of 1669 patients diagnosed with all types of somatic chronic disease(s), recruited in 2007 to 2010. Of this sample 1377 persons filled in either a postal (n = 1336) or internet (n = 41) questionnaire (response rate 83%). Additionally 225 of 259 COPD patients, who had been recruited from general practices from 2007 till early in 2011 via the same standardized procedure for a disease-specific study, participated in the same survey (response rate 87%). Hence, the total group of participants for this study comprised 1602 chronically ill patients derived from 82 general practices (Figure 1).


Individual care plans for chronically ill patients within primary care in the Netherlands: Dissemination and associations with patient characteristics and patient-perceived quality of care.

Jansen DL, Heijmans M, Rijken M - Scand J Prim Health Care (2015)

Flowchart study sample.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834496&req=5

Figure 1: Flowchart study sample.
Mentions: In April 2011, the panel consisted of 1669 patients diagnosed with all types of somatic chronic disease(s), recruited in 2007 to 2010. Of this sample 1377 persons filled in either a postal (n = 1336) or internet (n = 41) questionnaire (response rate 83%). Additionally 225 of 259 COPD patients, who had been recruited from general practices from 2007 till early in 2011 via the same standardized procedure for a disease-specific study, participated in the same survey (response rate 87%). Hence, the total group of participants for this study comprised 1602 chronically ill patients derived from 82 general practices (Figure 1).

Bottom Line: Patients with a low educational level and patients with poor(er) self-rated health were more likely to have an ICP.Compared with patients without an ICP, patients with an ICP more often reported that the care they received was patient-centred, proactive, planned, and included collaborative goal setting, problem-solving, and follow-up support.More research is needed to gain insight into the effectiveness of ICPs to improve the quality of chronic illness care in various patient populations.

View Article: PubMed Central - PubMed

Affiliation: NIVEL, Netherlands Institute for Health Services Research , Utrecht , The Netherlands.

ABSTRACT

Objective: To examine the use of individual care plans (ICPs) within primary chronic illness care in the Netherlands, and to explore the relationships between ICP use, patient characteristics, and patient-perceived quality of care.

Design: Cross-sectional study using survey data from a panel of chronically ill patients and medical registration data provided by their general practices.

Setting and subjects: A sample of 1377 patients with somatic chronic disease(s) randomly selected in general practices throughout the Netherlands, supplemented with a sample of 225 COPD patients, also recruited from general practices.

Main outcome measures: (i) Percentage of ICP use based on self-report by chronically ill patients, and (ii) patient-perceived quality of care as assessed using the Patient Assessment of Chronic Illness Care (PACIC).

Results: ICP use among the total generic sample was low (9%), but slightly higher (13%) among patients diagnosed with diabetes or COPD, diseases for which disease management programmes have been set up in the Netherlands. Patients with a low educational level and patients with poor(er) self-rated health were more likely to have an ICP. Compared with patients without an ICP, patients with an ICP more often reported that the care they received was patient-centred, proactive, planned, and included collaborative goal setting, problem-solving, and follow-up support.

Conclusion and implications: Findings reveal a discrepancy between practice and policy aspirations regarding ICP use in primary chronic illness care. More research is needed to gain insight into the effectiveness of ICPs to improve the quality of chronic illness care in various patient populations.

Show MeSH
Related in: MedlinePlus