Elements of Effective Chronic Care: A Model for Optimizing Outcomes for the Chronically Ill

被引:24
作者
Austin, Brian
Wagner, Edward
Hindmarsh, Michael
Davis, Connie
机构
关键词
care delivery; system redesign; chronic illness; epilepsy; medical care; patient education;
D O I
10.1006/ebeh.2000.0105
中图分类号
B84 [心理学]; C [社会科学总论]; Q98 [人类学];
学科分类号
03 ; 0303 ; 030303 ; 04 ; 0402 ;
摘要
Current estimates are that there are 2.3 million individuals with epilepsy among 99 million Americans suffering from chronic medical conditions. The healthcare system is designed to treat acutely ill patients and, as a result, often fails to meet the needs of the chronically ill. Care is provided in brief, problem-focused visits. Multiple studies have shown that this type of standard practice produces suboptimal care and outcomes, and is unsatisfactory to both patients and care providers. We developed the Chronic Care Model in an effort to synthesize system and practice changes associated with better outcomes. In patient care as described in this model, patient-provider interactions are planned in advance in accordance with evidence-based guidelines. A primary focus is on assisting patients and their families in becoming competent self-managers. The Chronic Care Model has been successfully implemented by more than 200 healthcare systems. In this paper, we explore the applicability of the Chronic Care Model in managing patients with epilepsy. (C) 2000 Academic Press
引用
收藏
页码:S15 / S20
页数:6
相关论文
共 25 条
[1]   Nurse case management to improve glycemic control in diabetic patients in a health maintenance organization - A randomized, controlled trial [J].
Aubert, RE ;
Herman, WH ;
Waters, J ;
Moore, W ;
Sutton, D ;
Peterson, BL ;
Bailey, CM ;
Koplan, JP .
ANNALS OF INTERNAL MEDICINE, 1998, 129 (08) :605-+
[2]   A randomized trial of group outpatient visits for chronically ill older HMO members: The cooperative health care clinic [J].
Beck, A ;
Scott, J ;
Williams, P ;
Robertson, B ;
Jackson, D ;
Gade, G ;
Cowan, P .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 1997, 45 (05) :543-549
[3]   Disease management - Promises and pitfalls [J].
Bodenheimer, T .
NEW ENGLAND JOURNAL OF MEDICINE, 1999, 340 (15) :1202-1205
[4]  
Boult C, 1999, AM J MANAG CARE, V5, P1162
[5]  
*EP FDN, 1999, EP REP NAT
[6]  
Funnell M M, 1991, Diabetes Educ, V17, P37, DOI 10.1177/014572179101700108
[7]   EXPANDING PATIENT INVOLVEMENT IN CARE - EFFECTS ON PATIENT OUTCOMES [J].
GREENFIELD, S ;
KAPLAN, S ;
WARE, JE .
ANNALS OF INTERNAL MEDICINE, 1985, 102 (04) :520-528
[8]   EDUCATING PHYSICIANS FOR POPULATION-BASED CLINICAL-PRACTICE [J].
GREENLICK, MR .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1992, 267 (12) :1645-1648
[9]   REDUCTION IN RESOURCE UTILIZATION BY AN ASTHMA OUTREACH PROGRAM [J].
GREINEDER, DK ;
LOANE, KC ;
PARKS, P .
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE, 1995, 149 (04) :415-420
[10]  
Gruman J, 1998, J Ambul Care Manage, V21, P1