2014
Short and long term improvements in quality of chronic care delivery predict program sustainability
Publication
Publication
Social Science & Medicine , Volume 101 p. 148- 154
Empirical evidence on sustainability of programs that improve the quality of care delivery over time is
lacking. Therefore, this study aims to identify the predictive role of short and long term improvements in
quality of chronic care delivery on program sustainability.
In this longitudinal study, professionals [2010 (T0): n ¼ 218, 55% response rate; 2011 (T1): n ¼ 300, 68%
response rate; 2012 (T2): n ¼ 265, 63% response rate] from 22 Dutch disease-management programs
completed surveys assessing quality of care and program sustainability. Our study findings indicated that
quality of chronic care delivery improved significantly in the first 2 years after implementation of the
disease-management programs. At T1, overall quality, self-management support, delivery system design,
and integration of chronic care components, as well as health care delivery and clinical information
systems and decision support, had improved. At T2, overall quality again improved significantly, as did
community linkages, delivery system design, clinical information systems, decision support and integration
of chronic care components, and self-management support. Multilevel regression analysis
revealed that quality of chronic care delivery at T0 (p < 0.001) and quality changes in the first (p < 0.001)
and second (p < 0.01) years predicted program sustainability. In conclusion this study showed that
disease-management programs based on the chronic care model improved the quality of chronic care
delivery over time and that short and long term changes in the quality of chronic care delivery predicted
the sustainability of the projects.
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doi.org/10.1016/j.socscimed.2013.11.035, hdl.handle.net/1765/50560 | |
Social Science & Medicine | |
Organisation | Erasmus School of Health Policy & Management (ESHPM) |
Cramm, J., & Nieboer, A. (2014). Short and long term improvements in quality of chronic care delivery predict program sustainability. Social Science & Medicine, 101, 148–154. doi:10.1016/j.socscimed.2013.11.035 |