The impact of a primary care e-communication intervention on the participation of chronic disease patients who had not reached guideline suggested treatment goals

2016 ◽  
Vol 99 (4) ◽  
pp. 530-541 ◽  
Author(s):  
Marie-Thérèse Lussier ◽  
Claude Richard ◽  
Emma Glaser ◽  
Denis Roberge
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Communication Intervention ◽  
Treatment Goals ◽  
Chronic Disease Patients ◽  
The Impact

scholarly journals Long-term effectiveness of elderly health care voucher scheme strategies: a system dynamics simulation analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ka Chun Chong ◽  
Hong Fung ◽  
Carrie Ho Kwan Yam ◽  
Patsy Yuen Kwan Chau ◽  
Tsz Yu Chow ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Public Sector ◽  
System Dynamics ◽  
The Elderly ◽  
Healthcare Services ◽  
Dynamics Simulation ◽  
Public And Private ◽  
The Public ◽  
The Impact

Abstract Background The elderly healthcare voucher (EHCV) scheme is expected to lead to an increase in the number of elderly people selecting private primary healthcare services and reduce reliance on the public sector in Hong Kong. However, studies thus far have reported that this scheme has not received satisfactory responses. In this study, we examined changes in the ratio of visits between public and private doctors in primary care (to measure reliance on the public sector) for different strategic scenarios in the EHCV scheme. Methods Based on comments from an expert panel, a system dynamics model was formulated to simulate the impact of various enhanced strategies in the scheme: increasing voucher amounts, lowering the age eligibility, and designating vouchers for chronic conditions follow-up. Data and statistics for the model calibration were collected from various sources. Results The simulation results show that the current EHCV scheme is unable to reduce the utilization of public healthcare services, as well as the ratio of visits between public and private primary care among the local aging population. When comparing three different tested scenarios, even if the increase in the annual voucher amount could be maintained at the current pace or the age eligibility can be lowered to include those aged 60 years, the impact on shifts from public-to-private utilization were insignificant. The public-to-private ratio could only be marginally reduced from 0.74 to 0.64 in the first several years. Nevertheless, introducing a chronic disease-oriented voucher could result in a significant drop of 0.50 in the public-to-private ratio during the early implementation phase. However, the effect could not be maintained for an extended period. Conclusions Our findings will assist officials in improving the design of the EHCV scheme, within the wider context of promoting primary care among the elderly. We suggest that an additional chronic disease-oriented voucher can serve as an alternative strategy. The scheme must be redesigned to address more specific objectives or provide a separate voucher that promotes under-utilized healthcare services (e.g., preventive care), instead of services designed for unspecified reasons, which may lead to concerns regarding exploitation.

scholarly journals Managing Chronic Disease in Ontario Primary Care: The Impact of Organizational Factors

2009 ◽  
Vol 7 (4) ◽  
pp. 309-318 ◽  
Author(s):  
G. M. Russell ◽  
S. Dahrouge ◽  
W. Hogg ◽  
R. Geneau ◽  
L. Muldoon ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Organizational Factors ◽  
The Impact

scholarly journals Hospital-based chronic disease care model: protocol for an effectiveness and implementation evaluation

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e037843
Author(s):  
Jennifer Sumner ◽  
Jason Phua ◽  
Yee Wei Lim
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Emergency Room ◽  
Clinical Outcomes ◽  
Qualitative Data ◽  
Emergency Room Visit ◽  
Type I ◽  
Care Model ◽  
Implementation Evaluation ◽  
Chronic Disease Patients

IntroductionNovel and efficient healthcare approaches are needed to better serve increasingly older chronic disease patients. Many effective integrated chronic disease management strategies have emerged from the primary care sector. However, in many Asian and developing countries, primary care is underdeveloped, and patients prefer secondary-based services. The Integrated Generalist-led Hospital (IGH) care model is a new approach, which may be better suited for chronic disease patients in the local context.Methods and analysisA hybrid type I study on the effectiveness and implementation of the IGH care model will be conducted. Implementation evaluation will be informed by the Consolidated Framework of Implementation Research (CFIR). Quantitative and qualitative data will be collected through in-depth interviews and focus group discussions with staff, a staff survey, patient interviews, clinical outcomes and cost data. Clinical outcomes include the length of stay, readmission, emergency room visit rate and mortality. Clinical outcomes will be summarised and compared with a propensity-matched ‘usual care’ group (derived from the general medicine ward(s) at a separate hospital). The Kaplan-Meier approach will be used to estimate time until death and time until first readmission (both within 30 days of discharge) and time until discharge. Multivariate regression models will be used to investigate the association between the care model and occurrence of readmission, emergency room visit and death, all within 30 days of discharge. Qualitative data will be analysed using a thematic analysis method. Qualitative and quantitative data will also be coded according to the five domains of the CFIR.Ethics and disseminationThis protocol was reviewed and approved by the National Healthcare Group Domain Specific Review Board (NHG DSRB 2019/00308). Results will be published in peer-reviewed scientific journals and conference presentations. Findings will also be discussed with key stakeholders through local dissemination events.

scholarly journals Do primary care physicians coordinate ambulatory care for chronic disease patients in Canada?

2014 ◽  
Vol 15 (1) ◽  
Author(s):  
Alan Katz ◽  
Patricia Martens ◽  
Dan Chateau ◽  
Bodgan Bogdanovic ◽  
Ina Koseva
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Ambulatory Care ◽  
Primary Care Physicians ◽  
Chronic Disease Patients

Practice strategies to improve primary care for chronic disease patients under a pay-for-value program

Healthcare ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Dori A. Cross ◽  
Paige Nong ◽  
Christy Harris-Lemak ◽  
Genna R. Cohen ◽  
Ariel Linden ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Chronic Disease Patients

scholarly journals Nurses’ knowledge of chronic disease management

2014 ◽  
Vol 19 (1) ◽  
Author(s):  
Saloshni Naidoo ◽  
Ozayr H. Mahomed ◽  
Shaidah Asmall ◽  
Myra Taylor
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Disease Management ◽  
Chronic Diseases ◽  
Chronic Disease Management ◽  
Diabetes Management ◽  
T Test ◽  
And Control ◽  
The Impact ◽  
Nurses Knowledge

Background: Chronic diseases of lifestyle are detrimentally affecting South Africans. National Health Insurance, which is intended to improve care, requires capacity building for nurses at primary care clinics to ensure appropriate service provision.Objective: This study’s objective was to evaluate the impact of the ‘Primary Care 101’ chronic disease management guideline and training on nurses’ knowledge of chronic diseases management.Method: A population-based, unblinded, stratifid cluster randomised controlled trialwith intervention (n = 20) and control clinics (n = 10) in three South African districts was conducted over six months in 2012. Nurses in the clinics participated in surveying knowledge on management of tuberculosis, human immunodefiiency virus infection, mental health, epilepsy, diabetes, hypertension and asthma and chronic obstructive pulmonary disease (COPD). All nurses were surveyed at baseline and six months later. Intervention clinic nurses were also surveyed immediately after training and three months post-training. Data were analysed using SPSS version 19 (SPSS Inc., Chicago, IL).Total mean knowledge percentage scores were calculated for each chronic disease. Mean knowledge percentage score changes between baseline and six months amongst all nurses and between intervention and control clinic nurses were compared using the paired samples t-test and independent samples t-test respectively.Results: There were signifiant improvements in nurses’ knowledge of hypertension and diabetes management over six months. Knowledge about asthma and COPD management decreased in all districts and nurse categories.Conclusion: The improvements in nurses’ knowledge can ensure improved patientmanagement, but attention to asthma and COPD management is required.Agtergrond: Chroniese lewenstylsiektes beïnvloed Suid-Afrikaners nadelig. Die nasionale gesondheidsversekering, wat ten doel het om sorg te verbeter, vereis kapasiteitsbou vir verpleegsters by primêre-sorg-klinieke om sodoende toepaslike dienslewering te verseker.Doelwitte: Hierdie studie se doel was te evalueer wat die impak van die ‘Primary Care 101’ chroniese siekte bestuursriglyn, asook opleiding is op verpleegsters se kennis van hoe om chroniese siektes te bestuur.Metode: ’n Bevolkingsgebaseerde, onverblinde, ewekansige gekontroleerde trossteekproef met ingrypings- (n = 20) en kontrole-klinieke (n = 10) is oor ’n tydperk van ses maande in 2012 in drie Suid-Afrikaanse distrikte uitgevoer. Verpleegsters in hierdie klinieke het deelgeneem aan ’n opname oor hul kennis oor die bestuur van tuberkulose, menslike immuniteitsgebreksvirus-infeksie, geestesgesondheid, epilepsie, diabetes, hoë bloeddruk, asook asma en chroniese obstruktiewe longsiekte (COPD). Alle verpleegsters is by die basislyn ondervra en ses maande later. Intervensie kliniekverpleegsters is ook ondervra onmiddellik na die opleiding en drie maande post-opleiding. Data is ontleed met behulp van SPSS, weergawe 19 (SPSS Inc, Chicago, IL). Totale gemiddelde kennis persentasietellings isvir elke chroniese siekte bereken. Veranderinge in die gemiddelde kennis persentasietellings tussen die basislyn en ses maande later is onder alle verpleegsters, asook tussen ingrypingsen kontrole-kliniekverpleegsters vergelyk met behulp van die gepaarde steekproef t-toets en die onafhanklike steekproef t-toets onderskeidelik.Resultate: Daar was ’n aansienlike verbetering in verpleegsters se kennis oor die bestuur van hoë bloeddruk en diabetes na ses maande. Kennis oor die bestuur van asma en COPD het in alle distrikte en verpleegster-kategorieë afgeneem.Gevoltrekking: Die verbetering in die verpleegsters se kennis kan verbeterde pasiëntbestuur verseker, maar die bestuur van asma en COPD vereis verdere aandag.

scholarly journals Context-Aware Systems for Chronic Disease Patients: Scoping Review (Preprint)

2018 ◽  
Author(s):  
Kathleen Yin ◽  
Liliana Laranjo ◽  
Huong Ly Tong ◽  
Annie YS Lau ◽  
A Baki Kocaballi ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Chronic Conditions ◽  
Management Practices ◽  
Context Aware ◽  
Adaptive Services ◽  
Chronic Disease Patients ◽  
Health Related ◽  
Patient Work ◽  
Context Aware System ◽  
The Impact

BACKGROUND Context-aware systems, also known as context-sensitive systems, are computing applications designed to capture, interpret, and use contextual information and provide adaptive services according to the current context of use. Context-aware systems have the potential to support patients with chronic conditions; however, little is known about how such systems have been utilized to facilitate patient work. OBJECTIVE This study aimed to characterize the different tasks and contexts in which context-aware systems for patient work were used as well as to assess any existing evidence about the impact of such systems on health-related process or outcome measures. METHODS A total of 6 databases (MEDLINE, EMBASE, CINAHL, ACM Digital, Web of Science, and Scopus) were scanned using a predefined search strategy. Studies were included in the review if they focused on patients with chronic conditions, involved the use of a context-aware system to support patients’ health-related activities, and reported the evaluation of the systems by the users. Studies were screened by independent reviewers, and a narrative synthesis of included studies was conducted. RESULTS The database search retrieved 1478 citations; 6 papers were included, all published from 2009 onwards. The majority of the papers were quasi-experimental and involved pilot and usability testing with a small number of users; there were no randomized controlled trials (RCTs) to evaluate the efficacy of a context-aware system. In the included studies, context was captured using sensors or self-reports, sometimes involving both. Most studies used a combination of sensor technology and mobile apps to deliver personalized feedback. A total of 3 studies examined the impact of interventions on health-related measures, showing positive results. CONCLUSIONS The use of context-aware systems to support patient work is an emerging area of research. RCTs are needed to evaluate the effectiveness of context-aware systems in improving patient work, self-management practices, and health outcomes in chronic disease patients.

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