A Case for the Chronic Disease Management and the Integrated Care Model for Pain Medicine: An Affordable Care Act Imperative and Global Trend

Pain Medicine ◽  
2015 ◽  
Vol 16 (9) ◽  
pp. 1663-1665
Author(s):  
Kayode Williams
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Integrated Care ◽  
Affordable Care Act ◽  
Chronic Disease Management ◽  
Pain Medicine ◽  
Care Model ◽  
Global Trend

scholarly journals Professional nurses’ perceptions and experiences with the implementation of an integrated chronic care model at primary healthcare clinics in South Africa

Curationis ◽  
2017 ◽  
Vol 40 (1) ◽  
Author(s):  
Ozayr H. Mahomed ◽  
Shaidah Asmall
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Primary Healthcare ◽  
Chronic Care Model ◽  
Chronic Care ◽  
Chronic Disease Management ◽  
Management Model ◽  
Care Model ◽  
Professional Nurses ◽  
Primary Healthcare Clinics

Background: An integrated chronic disease management model has been implemented across primary healthcare clinics in order to transform the delivery of services for patients with chronic diseases. The sustainability and rapid scale-up of the model is dependent on positive staff perceptions and experiences.Objectives: The aim of the study was to determine the perceptions and experiences of professional nurses with the integrated chronic care model that has been implemented.Method: A cross-sectional descriptive survey utilising a self-administered questionnaire was conducted amongst all professional nurses who were involved in delivering primary healthcare services at the 42 implementing facilities in September 2014. Each facility has between four and eight professional nurses providing a service daily at the facilitiesResults: A total of 264 professional nurses participated in the survey. Prior to the implementation, 34% (91) of the staff perceived the model to be an added programme, whilst 36% (96) of the staff experienced an increased workload. Staff noted an improved process of care, better level of interaction with patients, improved level of knowledge and better teamwork coupled with an improved level of satisfaction with the work environment at the clinic after implementation of the integrated chronic disease model.Conclusion: Professional nurses have a positive experience with the implementation of the integrated chronic disease management model.

scholarly journals Chronic disease management: Discussing the perspectives of general practitioners in Italy

2019 ◽  
Vol 33 (1) ◽  
pp. 13-23
Author(s):  
Sara Barsanti ◽  
Francesca Guarneri
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
General Practitioners ◽  
Chronic Care Model ◽  
Chronic Care ◽  
Chronic Disease Management ◽  
Point Of View ◽  
Care Model ◽  
Chronic Patients ◽  
Bonferroni Test

The aim of this paper is to provide an overview of general practitioners’ perspectives across key criteria for effective chronic disease management. The study setting is the Tuscany Region in Italy that implemented the Chronic Care Model in 2010 with multidisciplinary team to assist chronic patients. We used the results of a web-based survey of general practitioners (N = 1136) conducted in 2015 to compare the experiences and satisfaction of general practitioners involved (group 1) and not involved (group 2) in the Chronic Care Model. The analysis included all general practitioners, and compared the two groups’ perspectives of the different core aspects of Chronic Care Model through conducting an ANOVA analysis and Bonferroni test. General practitioners involved in the Chronic Care Model are found to be more favourably disposed toward measurement and benchmarking, and more satisfied in terms of decision support system. Conversely, no significant differences were found in terms of collaboration with specialists, which remains weak and in terms of community collaboration and involvement. This study provides a detailed investigation of the implementation of Disease Management Programs, by considering the professional point of view.

Connected health and integrated care: Toward new models for chronic disease management

Maturitas ◽  
2015 ◽  
Vol 82 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Ioanna G. Chouvarda ◽  
Dimitrios G. Goulis ◽  
Irene Lambrinoudaki ◽  
Nicos Maglaveras
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Integrated Care ◽  
Chronic Disease Management ◽  
Connected Health ◽  
New Models

Increasing the Involvement of Specialist Physicians in Chronic Disease Management

2008 ◽  
Vol 13 (1_suppl) ◽  
pp. 52-56 ◽  
Author(s):  
Dylan Taylor ◽  
Michele Lahey
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Ambulatory Care ◽  
Chronic Care Model ◽  
Chronic Care ◽  
Chronic Disease Management ◽  
Care Delivery ◽  
Multidisciplinary Teams ◽  
Outpatient Services ◽  
Care Model

Background The Capital Health (CH) region in Alberta serves the population of the Edmonton area as well as a large referral population in western Canada. CH is responsible for the delivery of the spectrum of patient care, from inpatient to outpatient services. Growth in outpatient care, in particular, has led to the development of several ambulatory care facilities from which the delivery of care to several populations with a chronic disease will be coordinated. Assessment of problem The traditional model of care delivery is unsuited to the management of chronic diseases. Physicians must be part of the planning and implementation of new models if they are to be successful and sustainable. The concept of integration into a delivery team is not well understood or practised. This is not conducive to the integration of specialist physicians into multidisciplinary teams in ambulatory care that serves the needs of patients from a large geographic area. Results Chronic disease management using the Chronic Care Model has proven to be an effective method of delivering care to this wide population. Specialist physicians have not always taken advantage of opportunities to be involved in the planning and development of such new health care projects. In CH, physician integration in the planning, development and implementation of this new model has proven vital to its success. Strategies for change We based our strategy for change on Wagner's Chronic Care Model. This involved eight steps, the first four of which have been completed and the fifth and sixth are underway. Lessons and messages Five factors contributed to the successful integration of specialist physicians in chronic disease management: collaboration between disciplines and organizations; creating patient-centred services; organizational commitments; strong clinical leadership; and early involvement of clinicians.

Medicare and chronic disease management: integrated care as an exceptional circumstance?

2010 ◽  
Vol 34 (2) ◽  
pp. 152 ◽  
Author(s):  
Michael J. Taylor ◽  
Hal Swerissen
Keyword(s):  
Quality Improvement ◽  
Chronic Disease ◽  
Disease Management ◽  
Diabetic Patient ◽  
Patient Care ◽  
Integrated Care ◽  
Chronic Disease Management ◽  
Hypothetical Patient ◽  
Exceptional Circumstance

Chronic disease represents a significant challenge to the design and reform of the Australian healthcare system. The Medicare Benefits Schedule (MBS) provides a framework of numerous chronic disease management programs; however, their use at the patient level is complex. This analysis of the MBS chronic disease framework uses a hypothetical case study of a diabetic patient (with disease-related complications and a complex psychosocial background) to illustrate the difficulties in delivering appropriate multidisciplinary chronic disease care under the MBS. The complexities at each step – from care planning, service provision, and monitoring and review – are described, as are the intricacies involved in providing patient care under different MBS programs as well as those in the broader health and community care system. As demonstrated by this case study, under certain circumstances the provision of truly integrated care to this hypothetical patient would constitute an ‘exceptional circumstance’ under the MBS. Although quality improvement efforts can improve functioning within the limitations of the current system, system-wide reforms are necessary to overcome complexity and fragmentation. What is known about the topic?Chronic disease management requires optimal health system design to provide appropriate patient care. In Australia, the Medicare Benefits Schedule (MBS) provides chronic disease-focussed programs, but the multitude of available programs and items are administratively complex, overlapping and subject to claiming incompatibilities. What does this paper add? This paper illustrates the complexity of the various MBS programs for chronic disease management using a case study of the potential service response to a single diabetic patient with disease-related complications and a complex psychosocial background. This analysis illustrates the manifold problematic interactions and incompatibilities that may arise in relation to this hypothetical patient. What are the implications for practitioners?Under the current MBS framework, providing patients with optimum chronic disease management requires both clinical and administrative skill on the part of GPs. Time spent on administrative requirements is time away from clinical care. Although quality improvement efforts may improve functioning within the existing system to a certain extent, broader system reforms are necessary to support optimal chronic disease management in Australia.

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