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Features of the Chronic Care Model (CCM) Associated with Behavioral Counseling and Diabetes Care in Community Primary Care
- Source :
- The Journal of the American Board of Family Medicine. 23:295-305
- Publication Year :
- 2010
- Publisher :
- American Board of Family Medicine (ABFM), 2010.
-
Abstract
- Background: The Chronic Care Model (CCM) was developed to improve chronic disease care, but it may also inform delivery of other types of preventive care. Using hierarchical analyses of service delivery to patients, we explored associations of CCM implementation with diabetes care and counseling for diet or weight loss and physical activity in community-based primary care offices. Methods: Secondary analysis focused on baseline data from 25 practices (with an average of 4 physicians per practice) participating in an intervention trial targeting improved colorectal cancer screening rates. This intervention made no reference to the CCM. CCM implementation was measured through staff and clinical management surveys and was associated with patient care indicators (chart audits and patient questionnaires). Results: Overall, practices had low levels of CCM implementation. However, higher levels of CCM implementation were associated with better diabetes assessment and treatment of patients (P = .009 and .015, respectively), particularly among practices open to “innovation.” Physical activity counseling for obese and, particularly, overweight patients was strongly associated with CCM implementation (P = .0017), particularly among practices open to “innovation”; however, this association did not hold for overweight and obese patients with diabetes. Conclusions: Very modest levels of CCM implementation in unsupported primary care practices are associated with improved care for patients with diabetes and higher rates of behavioral counseling. Incremental incorporation of CCM components is an option, especially for community practices with stretched resources and with cultures of “innovativeness.”
- Subjects :
- Male
medicine.medical_specialty
Cross-sectional study
Directive Counseling
Motor Activity
Overweight
Article
Ambulatory care
Behavior Therapy
Surveys and Questionnaires
Weight Loss
Health care
Confidence Intervals
Diabetes Mellitus
Odds Ratio
Humans
Medicine
Community Health Services
Obesity
Disease management (health)
Curative care
Aged
Chronic care
Primary Health Care
business.industry
Public Health, Environmental and Occupational Health
Disease Management
Middle Aged
Diet
Cross-Sectional Studies
Logistic Models
Health Care Surveys
Models, Organizational
Family medicine
Chronic Disease
Female
medicine.symptom
Family Practice
business
Subjects
Details
- ISSN :
- 15587118 and 15572625
- Volume :
- 23
- Database :
- OpenAIRE
- Journal :
- The Journal of the American Board of Family Medicine
- Accession number :
- edsair.doi.dedup.....c58dd1f8c81f653f0f3707eff4f740e3