Does the Chronic Care Model Serve Also as a Template for Improving Prevention?

Glasgow, Russell E.; Orleans, C. Tracy; Wagner, Edward H.; Curry, Susan J.; Solberg, Leif I.

doi:10.1111/1468-0009.00222

Cited by 384 publications

(322 citation statements)

References 84 publications

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“…Some have suggested that health care providers do not often think about prevention in those with disabilities 9 or chronic illness. 1,10 The results of this survey demonstrate that veterans with SCI want to discuss these issues. Of interest, although subjects did want to discuss diet and exercise, the majority of patients did not indicate a desire to discuss obesity.…”

Section: Discussionmentioning

confidence: 88%

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Patients' perspective on the comprehensive preventive health evaluation in veterans with spinal cord injury

et al. 2005

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Study design: Survey research methods. Objectives: To assess patient satisfaction with the annual comprehensive preventative health evaluation (CPHE) and to determine if the patient's needs were being met. Setting: Department of Veterans Affairs National Survey, United States. Methods: A total of 853 subjects with spinal cord injuries participated in a mailed survey regarding the annual CPHE. Subjects were asked about satisfaction with the examination, preferences on how the examination is conducted and whether their needs were being met with the examination. Results: In all, 76% of the subjects that responded to the survey had completed a CPHE within the previous year. Subjects cited getting their medication and supplies refilled and talking to the doctor as the top two reasons for completing the evaluation. Subjects indicated that they would most like to discuss their muscle strength and weakness, bladder care, chronic pain, digestion and bowel care issues, and equipment problems during their evaluation. The majority of subjects (81%) indicated that they were satisfied with the CPHE. Subjects that were satisfied with the CPHE were also more satisfied with other aspects of care as well. Conclusion: The majority of respondents had completed a CPHE within the previous year. Most respondents cite health issues related to the spinal cord injury as areas they would most like to discuss during the evaluation. The majority of subjects were satisfied with the conduct of the CPHE.

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Section: Discussionmentioning

confidence: 88%

“…1 The Chronic Care Model is a conceptual system of care that integrates elements of a health system organization to promote productive interactions between an informed activated patient and a prepared practice team. 2 VA leadership supports care for veterans with SCI.…”

Section: Introductionmentioning

confidence: 99%

Patients' perspective on the comprehensive preventive health evaluation in veterans with spinal cord injury

et al. 2005

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“…Deux des modèles prennent cependant en compte les milieux de vie des patients et intègrent une dimension éducative [16,17].…”

Section: Résultatsunclassified

Prévention et promotion de la santé : quels modèles pour soutenir l’évolution des pratiques en soins de santé primaires ?

Vanmeerbeek

Mathonet

Miermans³

et al. 2015

La Presse Médicale

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Prévention et promotion de la santé : quels modèles pour soutenir l'évolution des pratiques en soins de santé primaires ?Preventive health care and health promotion: which models for supporting the evolution of clinical practice in primary health care? Certains éléments valorisés par la promotion de la santé seraient intégrables aux pratiques de soins préventifs et curatifs : empowerment individuel des patients, prise en compte de leurs milieux de vie ; participation accrue à des réseaux locaux de professionnels de la santé ; intégration, au sein des mêmes structures, de l'approche individuelle et collective pour permettre la poursuite simultanée des objectifs deL'avis des patients/usagers est généralement absent dans l'élaboration des modèles opérationnels retrouvés dans la littérature scientifique médicale. 3 Résumé ObjectifsLes modèles opérationnels publiés concernant la prévention et la promotion de la santé en soins de santé primaires ont été recherchés dans le but de réaliser un inventaire fonctionnel et de formuler des hypothèses de travail sur l'efficacité et l'équité de la pratique clinique en prévention. MéthodeRevue narrative de littérature utilisant les mots-clés relatifs aux différents niveaux de prévention, à la promotion de la santé, aux soins de santé primaires, aux modèles de pratique et à la délivrance de soins. La diversité des modèles a conduit à une analyse multicritères. RésultatsDouze modèles ont été sélectionnés. Leurs caractéristiques sont distribuées irrégulièrement.Les modèles dont les auteurs annoncent qu'ils s'appliquent à la prévention décrivent majoritairement des approches centrées sur les individus dans le cadre de la relation médecin-patient, et prennent en compte l'organisation de la pratique. Certains modèles systémiques de type socio-écologique illustrent le concept de promotion de la santé : pratique éducative, ciblage sur des groupes ou des populations, prise en compte de milieux de vie et des déterminants sociaux de la santé. La place des patients dans l'élaboration des modèles est mineure, à l'image de leur implication comme acteurs dans les systèmes de soins. Les définitions des termes de prévention, promotion de la santé et éducation du patient diffèrent considérablement d'un modèle à l'autre. DiscussionOn dispose de peu d'informations sur l'application pratique des modèles ; les données d'évaluation sont parcellaires. 4Certains éléments valorisés par la promotion de la santé seraient intégrables aux pratiques de soins préventifs et curatifs : empowerment individuel des patients, prise en compte de leurs milieux de vie ; participation accrue à des réseaux locaux de professionnels de la santé ; intégration, au sein des mêmes structures, de l'approche individuelle et collective pour permettre la poursuite simultanée des objectifs de personnalisation, d'efficacité et d'équité. ConclusionCes évolutions ont des implications sur la formation des soignants, en termes d'aptitudes communicationnelles, de sensibilisation aux concepts de la santé publique et d'immersion précoce d...

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“…However more steps have to be implemented in order to provide the right level of prevention of chronic conditions. The application of the chronic care model would be beneficial in this respect with a greater control of patients, a greater role of nurses in primary care, and more resources devoted to provide information on the conditions identified in chronic patients (Glasgow et al, 2001). …”

Section: Pathways Towards the Optimal Modelmentioning

confidence: 99%

Pathways towards chronic care-focused healthcare systems: Evidence from Spain

et al. 2012

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AcknowledgementsThe authors are thankful to Mauricio Avendano-Pabón, Anna Maresso and Marta TraperoBertran for helpful comments on a preliminary version of this work, and Jonathan Cylus for his data support. Manuel García-Goñi research was supported by the project "La innovación en servicios y las interacciones entre servicios públicos y privados: el caso de la sanidad", financed by the Spanish Ministry of Science and Innovation. Any errors are the authors' responsibility. 2 AbstractIncreasing health care expenditures is a matter of concern in many countries, particularly in relation to the underlying drivers of such escalation which include ageing, medical innovation, and changes in the burden of disease e.g. prevalence of chronic diseases. Most health care systems in developed countries have been designed to 'cure' acute episodes, rather than to 'manage' chronic conditions, and thereby they are not adequately and efficiently organized to respond to the changing needs and preferences of consumers. New models of chronic care provision have been developed to respond to the changing burden of disease and there are already practical experiences in different countries showing their advantages but also the difficulties in their implementation. In this paper, we focus on the Spanish experience in terms of policy changes and pilot studies directed at testing the viability of transiting towards chronic care models. In particular, we utilize a framework that identifies and analyses the 10 key pre-conditions of high performing chronic-care based healthcare systems and apply it to the current Spanish NHS. We find that the design of the Spanish National Health System already meets some of those pre-conditions. However, other features are still in their early stages of development or being applied in restricted geographical and clinical contexts. We propose a pathway to walk the crucial challenge of the transition towards an optimal health system focused on chronic care. Given the current evidence and trends, we expect that the pathway for developing a chronicity strategy for the Spanish NHS will significantly transform its current healthcare delivery model in the next few years.

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Does the Chronic Care Model Serve Also as a Template for Improving Prevention?

Cited by 384 publications

References 84 publications

Patients' perspective on the comprehensive preventive health evaluation in veterans with spinal cord injury

Patients' perspective on the comprehensive preventive health evaluation in veterans with spinal cord injury

Prévention et promotion de la santé : quels modèles pour soutenir l’évolution des pratiques en soins de santé primaires ?

Pathways towards chronic care-focused healthcare systems: Evidence from Spain

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