Patient assessment of diabetes care in a pay-for-performance program

Chiu, Herng‐Chia; Hsieh, Hui‐Min; Lin, Ying‐Chin; Kuo, Shou‐Jen; Kao, Hao-Yun; Yeh, Shu-Chuan Jennifer; Chang, Wen‐Dien; Hsiao, Pi‐Jung; Chen, Yao-Shen; Lin, Shoei-Loong; Lo, Gin‐Ho; Ker, Chen‐Guo; Hung, Yu‐Han; Cheng, Hsien-An; Chou, Tiang-Hong; Chou, Sze-Yuan; Wang, Jao-Hsien; Wang, Chien-Fu

doi:10.1093/intqhc/mzv120

Cited by 15 publications

(8 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study, the overall PACIC score of 1.55 indicates that, in general, the congruence between the assessed care process and the CCM never occurred or occurred few times from the perspective of the participants. This result contrasts with other international studies that reached a total score higher than that presented in the current research, ranging from 2.33 to 4.19 12 - 14 , 23 - 25 , 32 . The only study at the national level, the one responsible for the translation of the questionnaire in the country, in Curitiba, reported a mean score of 2.86 6 .…”

Section: Discussioncontrasting

confidence: 99%

“…It should be emphasized that this questionnaire has been adapted and validated semantically and culturally by several groups interested in its use as a support tool for the diagnosis, adjustment, monitoring and evaluation of models of care to chronic conditions grounded in the Chronic Care Model, which has been tested in subjects with various chronic conditions, e.g. diabetes mellitus 11 - 14 , 23 - 24 ) and cardiovascular diseases 23 , 25 .…”

Section: Methodsmentioning

confidence: 99%

“…The PACIC emphasizes interactions between users and providers of care, especially aspects of assisted self-care; it includes the users’ evaluation of the frequency with which they are given opportunities to adhere to treatment in the last six months, to understand the care and support model and their participation in decision-making with respect to treatment, setting goals, support for problem solving, and contextualization of counseling, as well as their perception about the coordination of care and follow-up by the local team 6 . This questionnaire has also been considered sensitive to changes in chronic care provision, associated with other measures of productivity and system improvements, mainly with clinical and behavioral outcomes 12 - 14 .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Assessment of the quality of primary care for the elderly according to the Chronic Care Model

Silva

Soares

Silva³

et al. 2018

Rev. Latino-Am. Enfermagem

View full text Add to dashboard Cite

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.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Assessment of the quality of primary care for the elderly according to the Chronic Care Model

Silva

Soares

Silva³

et al. 2018

Rev. Latino-Am. Enfermagem

View full text Add to dashboard Cite

show abstract

“…These latter results are close to those from several studies conducted in the United States, with scores ranging from 3.0 to 3.2 and samples composed mainly of patients with type 2 diabetes, with a mean age ranging from 63.7 years to 65 years. Finally, the highest PACIC scores were obtained from a sample from Taiwan, mainly composed of female patients, with a score of 4.2 for the patients enrolled in a pay‐for‐performance program …”

Section: Discussionmentioning

confidence: 99%

Diabetes care: Comparison of patients' and healthcare professionals' assessment using the PACIC instrument

Gijs

Zuercher

Henry

et al. 2017

Evaluation Clinical Practice

View full text Add to dashboard Cite

Rationale, aims and objective Whereas the Patient Assessment of Chronic Illness Care (PACIC) instrument measures the extent to which care received by patients is congruent with the Chronic Care Model, the 5As model emphasizes self‐management and community resources, 2 key components of the Chronic Care Model. We aimed at comparing evaluation of diabetes care, as reported by patients with diabetes and healthcare professionals (HCPs), using these instruments. Methods Two independent samples, patients with diabetes (n = 395) and HCPs (including primary and secondary care physicians and nurses; n = 287), responded to the 20‐item PACIC and the six 5As model questions. The PACIC‐5A (questions scored on a 5‐point scale, 1 = never to 5 = always) was adapted for HCPs (modified‐PACIC‐5A). In both samples, means and standard deviations for each question as well as proportions of responses to each response modality were computed, and an overall score was calculated for the 20‐item PACIC. Results Patients' and HCPs' overall scores were 2.6 (SD 0.9) and 3.6 (SD 0.5), respectively, with HCPs reporting higher scores for all questions except 1. Patients' education and self‐management, referral/follow‐up and participation in community programs were rated as low by patients and HCPs. Conclusion Healthcare professionals, particularly diabetes specialists, tended to report better PACIC scores than patients, suggesting that care was not reported similarly when received or provided. Evaluation differences might be reduced by a closer collaboration between patients and HCPs, as well as the implementation of community‐based interventions considering more patients' perspectives such as patients' education and self‐management.

show abstract

“…28 An increased perception of patient-centered care is often associated with better outcomes in T2DM. 29 Patients who chose their primary care physician and report an easier time obtaining an appointment reported less dissatisfaction and increased medication adherence compared to those who had a physician assigned to them or had difficulty obtaining an appointment. 30–32 In terms of patient factors influencing dissatisfaction, those who reported poor health, failure to engage in self-management activities, inadequate patient education, or difficulty accessing diabetes care were more likely to report dissatisfaction.…”

Section: Introductionmentioning

confidence: 95%

The association of cumulative discrimination on quality of care, patient-centered care, and dissatisfaction with care in adults with type 2 diabetes

Cykert

Williams

Walker

et al. 2017

Journal of Diabetes and its Complications

View full text Add to dashboard Cite

Aims Discrimination is linked to negative health outcomes, but little research has investigated how the cumulative effect of discrimination impacts perceptions of care. This study investigated the influence of cumulative perceived discrimination on quality of care, patent-centeredness, and dissatisfaction with care in adults with type 2 diabetes. Methods 602 patients from two primary care clinics in Charleston SC. Linear regression models assessed associations between perceived discrimination and quality of care, patient-centered care, and dissatisfaction with care. The models control for race, site, age, gender, marital status, duration of diabetes, education, hours worked weekly, income, and health status. Results The mean age was 61.5 years, with 66.3% non-Hispanic blacks, and 41.9% earning less than $20,000 annually. In final adjusted analyses, lower patient-centered care was associated with a higher discrimination score (β=−0.28; p=0.006), reporting at least 1 category of discrimination (β=−1.47; p=0.002), and reporting at least 2 categories of discrimination (β=−1.34; p=0.004). Dissatisfaction with care was associated with at least 2 categories of discrimination (β=0.45; p=0.002). No significant associations were seen with quality of care indicators. Conclusions Increased cumulative discrimination was associated with decreased feeling of patient-centeredness and increased dissatisfaction with care. However, these perceptions of discrimination were not significantly associated with quality indicators.

show abstract

Patient assessment of diabetes care in a pay-for-performance program

Cited by 15 publications

References 35 publications

Assessment of the quality of primary care for the elderly according to the Chronic Care Model

Assessment of the quality of primary care for the elderly according to the Chronic Care Model

Diabetes care: Comparison of patients' and healthcare professionals' assessment using the PACIC instrument

The association of cumulative discrimination on quality of care, patient-centered care, and dissatisfaction with care in adults with type 2 diabetes

Contact Info

Product

Resources

About