Primary Healthcare Organization and Quality-of-Life Outcomes for Persons with Chronic Disease

Abstract

Purpose: To explore the association between primary healthcare (PHC) organizational model and health-related quality of life (HRqoL) in persons with chronic disease. Methods: We recruited 776 patients with a primary diagnosis of one of four chronic diseases from 33 PHC clinics. Patients were interviewed at baseline, 6, 12 and 18 months. We categorized PHC model by administrative type and by a taxonomy according to organizational attributes. HRqoL was measured by disease-specific questionnaires. Results: mean age was 67 years and 55.3% were female. PHC models differed with respect to case mix: community models served older patients with higher co-morbidity and lower health status. multilevel logistic regression revealed that none of the PHC organizational models was associated with HRqoL. Having fewer co-morbidities, higher self-rated health and not using home care services were associated with higher HRqoL. Conclusion: Despite their having patients with more complex health problems, HRqoL in patients of community practices was equivalent to that of patients in other types of PHC organizations.

Health-related quality of life and related factors among elderly persons under different aged care models in Guangzhou, China: a cross-sectional study

“…As the number of chronic diseases increased, the HRQoL of the elderly deteriorated, under both aged care models. This is consistent with previous studies showing that having a chronic disease could reduce HRQoL significantly and living with multiple chronic diseases could reduce HRQoL even further [ 33 , 34 ]. Second, a negative correlation was found between loneliness and HRQoL among elderly under different aged care models.…”

The impact of primary care reform on health system performance in Canada: a systematic review

“…The remaining 5 studies from Quebec and Alberta focused on the effects of team-based aspects of primary care reforms. [ 20 – 24 ] The publication dates spanned from 2009 to 2015. In 8 of the studies, specific sub-populations were studied all of which were comprised of individuals with chronic disease.…”

Impact of Type of Medical Specialist Involvement in Chronic Illness Care on Emergency Department Use

“…We followed a cohort of adults with CDs living in the Montreal and Montérégie regions of Quebec (Canada) between 2006 and 2008 ( Feldman et al 2012 ; Lemieux et al 2011 ). Out of the 675 primary care organizations found in these regions ( Gouvernement du Québec and Centre de recherche de l'Hôpital Charles LeMoyne 2009 ), we contacted 90 primary healthcare practices providing services for patients with CDs, representing all types of primary healthcare practice arrangements (solo, Conventional group practices, Family Medicine Groups, Community health centres and Hospital-based family medicine units) and having at least four PCPs when being a group practice.…”

“…Age, gender, highest level of education completed, area of residency (Montreal = urban, Montérégie = rural), co-morbidity and disease-specific health-related quality of life (HRQoL) were measured ( Feldman et al 2012 ). Co-morbidity level was measured by the number of reported conditions from a list of 17 common CDs.…”