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Reported experience of patients with single or multiple chronic diseases: empirical evidence from Italy
- Source :
- BMC Health Services Research, Vol 18, Iss 1, Pp 1-9 (2018), BMC Health Services Research
- Publication Year :
- 2018
- Publisher :
- BMC, 2018.
-
Abstract
- Background More and more countries have been implementing chronic care programs, such as the Chronic Care Model (CCM) to manage non-acute conditions of diseases in a more effective and less expensive way. Often, these programs aim to provide care for single conditions instead of the sum of diseases. This paper analyzes the satisfaction and better management of single and multiple chronic patients with the core elements of chronic care programs in Siena, Italy. In addition, the paper also considers whether the CCM introduced in Siena has any influence on satisfaction and better self-management. Methods Survey data from patients with single chronic (N = 500) and multiple chronic diseases (N = 454), assisted by the Local Health Authority in Siena (Tuscany, Italy), were considered for the analysis. Variables on education, monitoring system, proactivity, relational continuity, model of care (CCM versus no CCM) and patient demographics were used to detect which strategies are associated with a higher patient-reported ability to better self-manage the disease and overall patient satisfaction. Logistic and ordinary logistic models were executed on data related to patients with both single and multiple chronic diseases. Results The results showed that monitoring was the sole strategy associated with overall satisfaction and better self-management for both single and multiple chronic patients. Relational continuity also showed a significant positive association with better self-management perception for both patient groups, but had a positive association with patient satisfaction only for single chronic patients. Enrolment in the CCM was not associated with both overall satisfaction and better management for the two patient groups. Conclusions Strategies that are significantly associated with satisfaction and perception of better disease self-management were the same for both single and multiple chronic patients. The delivery of care based on the Siena CCM does not seem to make a difference in the perception of better self-management and overall satisfaction for all the patients. Other concurrent strategies implemented by the regional government in Tuscany on primary care monitoring and health promotion could partially explain why CCM does not have a significant influence.
- Subjects :
- Male
medicine.medical_specialty
Multi-morbidity
Health Status
Disease
Empirical Research
Health informatics
Health administration
03 medical and health sciences
0302 clinical medicine
Patient satisfaction
Patient Education as Topic
Surveys and Questionnaires
Self-management
Humans
Medicine
Multiple Chronic Conditions
030212 general & internal medicine
Aged
Chronic care
Primary Health Care
business.industry
030503 health policy & services
Health Policy
Public health
Nursing research
lcsh:Public aspects of medicine
Chronic care model
lcsh:RA1-1270
Italy
Family medicine
Chronic Disease
Monitoring system
Female
0305 other medical science
business
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14726963
- Volume :
- 18
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Health Services Research
- Accession number :
- edsair.doi.dedup.....e44ed9fc7d19638be03be9186aab8089