Identifying factors associated with experiences of coronary heart disease patients receiving structured chronic care and counselling in European primary care

Sabine Ludt, Jan Van Lieshout, Stephen Campbell, Justine Rochon, Dominik Ose, Tobias Freund, Michel Wensing, Joachim Szécsényi

Research output: Contribution to journalArticle

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Abstract

Background
Primary care for chronic illness varies across European healthcare systems. In patients suffering from coronary heart disease (CHD), factors associated with patients’ experiences of receiving structured chronic care and counselling at the patient and practice level were investigated.

Methods
In an observational study comprising 140 general practices from five European countries (Austria, Germany, the Netherlands, Switzerland and the United Kingdom), 30 patients with Coronary Heart Disease (CHD) per practice were chosen at random to partake in this research. Patients were provided with a questionnaire and the Patient Assessment of Chronic Illness Care (PACIC-5A) - instrument. Practice characteristics were assessed through a practice questionnaire and face to face interviews. Data were aggregated to obtain two practice scores representing quality management and CHD care, respectively. A hierarchical multilevel analysis was performed to examine the impact of patient and practice characteristics on PACIC scores.

Results
The final sample included 1745 CHD-patients from 131 general practices with a mean age of 67.8 (SD 9.9) years. The overall PACIC score was 2.84 (95%CI: 2.79; 2.89) and the 5A score reflecting structured lifestyle counselling was 2.75 (95% CI: 2.69; 2.79). At the patient level, male gender, more frequent practice contact and fewer related or unrelated conditions were associated with higher PACIC scores. At the practice level, performance scores reflecting quality management (p = 0.013) and CHD care (p = 0.009) were associated with improved assessment of the structured chronic care and counselling received.

Conclusions
Patients’ perceived quality of care varies. However, good practice management and organisation of care were positively reflected in patients’ assessments of receiving structured chronic illness care. This highlights the importance of integrating patient experiences into quality measurements to provide feedback to health care professionals
Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalBMC Health Services Research
Volume12
Issue number1
DOIs
Publication statusPublished - 2012
Externally publishedYes

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Coronary Disease
Counseling
Primary Health Care
Chronic Disease
General Practice
Delivery of Health Care
Multilevel Analysis
Quality of Health Care
Austria
Practice Management
Switzerland
Netherlands
Observational Studies
Germany
Life Style
Interviews
Research

Cite this

Ludt, Sabine ; Van Lieshout, Jan ; Campbell, Stephen ; Rochon, Justine ; Ose, Dominik ; Freund, Tobias ; Wensing, Michel ; Szécsényi, Joachim. / Identifying factors associated with experiences of coronary heart disease patients receiving structured chronic care and counselling in European primary care. In: BMC Health Services Research. 2012 ; Vol. 12, No. 1. pp. 1-11.
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abstract = "BackgroundPrimary care for chronic illness varies across European healthcare systems. In patients suffering from coronary heart disease (CHD), factors associated with patients’ experiences of receiving structured chronic care and counselling at the patient and practice level were investigated.MethodsIn an observational study comprising 140 general practices from five European countries (Austria, Germany, the Netherlands, Switzerland and the United Kingdom), 30 patients with Coronary Heart Disease (CHD) per practice were chosen at random to partake in this research. Patients were provided with a questionnaire and the Patient Assessment of Chronic Illness Care (PACIC-5A) - instrument. Practice characteristics were assessed through a practice questionnaire and face to face interviews. Data were aggregated to obtain two practice scores representing quality management and CHD care, respectively. A hierarchical multilevel analysis was performed to examine the impact of patient and practice characteristics on PACIC scores.ResultsThe final sample included 1745 CHD-patients from 131 general practices with a mean age of 67.8 (SD 9.9) years. The overall PACIC score was 2.84 (95{\%}CI: 2.79; 2.89) and the 5A score reflecting structured lifestyle counselling was 2.75 (95{\%} CI: 2.69; 2.79). At the patient level, male gender, more frequent practice contact and fewer related or unrelated conditions were associated with higher PACIC scores. At the practice level, performance scores reflecting quality management (p = 0.013) and CHD care (p = 0.009) were associated with improved assessment of the structured chronic care and counselling received.ConclusionsPatients’ perceived quality of care varies. However, good practice management and organisation of care were positively reflected in patients’ assessments of receiving structured chronic illness care. This highlights the importance of integrating patient experiences into quality measurements to provide feedback to health care professionals",
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Identifying factors associated with experiences of coronary heart disease patients receiving structured chronic care and counselling in European primary care. / Ludt, Sabine; Van Lieshout, Jan; Campbell, Stephen; Rochon, Justine; Ose, Dominik; Freund, Tobias; Wensing, Michel; Szécsényi, Joachim.

In: BMC Health Services Research, Vol. 12, No. 1, 2012, p. 1-11.

Research output: Contribution to journalArticle

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T1 - Identifying factors associated with experiences of coronary heart disease patients receiving structured chronic care and counselling in European primary care

AU - Ludt, Sabine

AU - Van Lieshout, Jan

AU - Campbell, Stephen

AU - Rochon, Justine

AU - Ose, Dominik

AU - Freund, Tobias

AU - Wensing, Michel

AU - Szécsényi, Joachim

PY - 2012

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N2 - BackgroundPrimary care for chronic illness varies across European healthcare systems. In patients suffering from coronary heart disease (CHD), factors associated with patients’ experiences of receiving structured chronic care and counselling at the patient and practice level were investigated.MethodsIn an observational study comprising 140 general practices from five European countries (Austria, Germany, the Netherlands, Switzerland and the United Kingdom), 30 patients with Coronary Heart Disease (CHD) per practice were chosen at random to partake in this research. Patients were provided with a questionnaire and the Patient Assessment of Chronic Illness Care (PACIC-5A) - instrument. Practice characteristics were assessed through a practice questionnaire and face to face interviews. Data were aggregated to obtain two practice scores representing quality management and CHD care, respectively. A hierarchical multilevel analysis was performed to examine the impact of patient and practice characteristics on PACIC scores.ResultsThe final sample included 1745 CHD-patients from 131 general practices with a mean age of 67.8 (SD 9.9) years. The overall PACIC score was 2.84 (95%CI: 2.79; 2.89) and the 5A score reflecting structured lifestyle counselling was 2.75 (95% CI: 2.69; 2.79). At the patient level, male gender, more frequent practice contact and fewer related or unrelated conditions were associated with higher PACIC scores. At the practice level, performance scores reflecting quality management (p = 0.013) and CHD care (p = 0.009) were associated with improved assessment of the structured chronic care and counselling received.ConclusionsPatients’ perceived quality of care varies. However, good practice management and organisation of care were positively reflected in patients’ assessments of receiving structured chronic illness care. This highlights the importance of integrating patient experiences into quality measurements to provide feedback to health care professionals

AB - BackgroundPrimary care for chronic illness varies across European healthcare systems. In patients suffering from coronary heart disease (CHD), factors associated with patients’ experiences of receiving structured chronic care and counselling at the patient and practice level were investigated.MethodsIn an observational study comprising 140 general practices from five European countries (Austria, Germany, the Netherlands, Switzerland and the United Kingdom), 30 patients with Coronary Heart Disease (CHD) per practice were chosen at random to partake in this research. Patients were provided with a questionnaire and the Patient Assessment of Chronic Illness Care (PACIC-5A) - instrument. Practice characteristics were assessed through a practice questionnaire and face to face interviews. Data were aggregated to obtain two practice scores representing quality management and CHD care, respectively. A hierarchical multilevel analysis was performed to examine the impact of patient and practice characteristics on PACIC scores.ResultsThe final sample included 1745 CHD-patients from 131 general practices with a mean age of 67.8 (SD 9.9) years. The overall PACIC score was 2.84 (95%CI: 2.79; 2.89) and the 5A score reflecting structured lifestyle counselling was 2.75 (95% CI: 2.69; 2.79). At the patient level, male gender, more frequent practice contact and fewer related or unrelated conditions were associated with higher PACIC scores. At the practice level, performance scores reflecting quality management (p = 0.013) and CHD care (p = 0.009) were associated with improved assessment of the structured chronic care and counselling received.ConclusionsPatients’ perceived quality of care varies. However, good practice management and organisation of care were positively reflected in patients’ assessments of receiving structured chronic illness care. This highlights the importance of integrating patient experiences into quality measurements to provide feedback to health care professionals

U2 - 10.1186/1472-6963-12-221

DO - 10.1186/1472-6963-12-221

M3 - Article

VL - 12

SP - 1

EP - 11

JO - BMC Health Services Research

JF - BMC Health Services Research

SN - 1472-6963

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