The Article in Brief

Care Quality and Implementation of the Chronic Care Model: A Quantitative Study

Leif I. Solberg, MD , and colleagues

Background A new approach is needed to improve the care of people with chronic diseases. The Chronic Care Model (description below) is widely accepted as a method for providing better care for chronically ill people. This study is one of the first to assess the efforts of a large medical group in implementing the Chronic Care Model (CCM). In particular, the study examined whether implementation of the CCM was associated with quality of care for patients with 3 common chronic conditions: diabetes, heart disease and depression.

(Description: From: http://www.improvingchroniccare.org/change/model/components.html: “The Chronic Care Model identifies the essential elements of a health care system that encourage high-quality chronic disease care. These elements are the community, the health system, self-management support, delivery system design, decision support and clinical information systems. Evidence-based change concepts under each element, in combination, foster productive interactions between informed patients who take an active part in their care and providers with resources and expertise. The model can be applied to a variety of chronic illnesses, health care settings and target populations. The bottom line is healthier patients, more satisfied providers, and cost savings.”)

What This Study Found During a 2-year period, the medical group improved its implementation of most elements of the CCM and its quality of care for patients with diabetes and heart disease. (There was little improvement in quality of care for patients with depression). However, there does not appear to be a relationship between implementation of the CCM and quality improvements for people with these conditions.

Implications

• Demonstrating a relationship between implementation of the CCM and improvements in quality measures for 3 chronic diseases may require larger changes, more participating clinics, changes in other CCM elements, or more sensitive measurement tools.
• Additional research is needed to help identify which interventions and care changes matter the most and how they are best implemented.