Quality of care for chronic illnesses

• Published in: International journal of health care quality assurance 2008-01, Vol.21 (2), p.190-202
• Main Authors: Øvretveit, John, Gillies, Robin, Rundall, Thomas G, Shortell, Stephen M, Brommels, Mats
• Format: Article
• Language: English
• Subjects: Asthma; Care management; Case management; Chronic Disease - therapy; Chronic illnesses; Chronic sickness; Communication; Communication technologies; Communications networks; Cost reduction; Diabetes; Disease management; Disease prevention; Evidence-Based Medicine; Feedback; Guideline Adherence; Health administration; Health care industry; Health promotion; Health Services Research; Heart failure; Humans; Independent practice associations; Information technology; Medical Records Systems, Computerized - utilization; Patient admissions; Physicians; Practice Guidelines as Topic; Prevention; Primary care; Primary health care; Primary Health Care - organization & administration; Primary Prevention - organization & administration; Public health; Quality; Quality of care; Quality of Health Care - organization & administration; Questionnaires; Reminder Systems; Research methodology; Studies; Suffering; Sweden
• ISSN: 0952-6862; 1758-6542
• DOI: 10.1108/09526860810859049

Purpose - The purpose of this paper is to discover the extent to which evidence-based practices and computer systems for managing chronic illness are used within Swedish primary health care.Design methodology approach - The methodology was a replication of a similar national USA survey study and an interview study.Findings - The findings show large variations and an under-use of a number of evidence-based care management practices and of IT for managing depression, heart disease, asthma, and diabetes in Sweden. Follow-up interview studies with heads of primary care centres gathered their views about the factors which helped and hindered improving care and prevention for these patient groups.Research limitations implications - The study data identify actions which would significantly improve the quality of care for people suffering from chronic illnesses. Effective prevention and management of chronic illness in primary care can reduce unnecessary patient suffering and lower costs of care.Originality value - Evidence of effective methods for managing these illnesses has been reported, but it is not known how widely these methods or information technology are used in primary care outside the USA. The paper gives the first comprehensive nation-wide data on the use of evidence-based practices and computer systems for managing chronic illness in primary care in a European public health care system. It provides information allowing targeted actions which would improve quality of care which are low cost and high cost saving in the long term.