Skip to main content
Top
Published in: BMC Health Services Research 1/2015

Open Access 01-06-2015 | Research article

The ideal healthcare: priorities of people with chronic conditions and their carers

Authors: Adem Sav, Sara S. McMillan, Fiona Kelly, Michelle A. King, Jennifer A. Whitty, Elizabeth Kendall, Amanda J. Wheeler

Published in: BMC Health Services Research | Issue 1/2015

Login to get access

Abstract

Background

It is well established that health consumer opinions should be considered in the design, delivery, and evaluation of health services. However, the opinions of people with chronic conditions and their carers and what they actually consider as ideal healthcare is limited. The aim of this study is to investigate the healthcare priorities of consumers with chronic conditions and their carers, if there are differences between these two groups, and if priorities differ depending on geographical location.

Methods

The nominal group technique was used as a method to identify what is currently important to, or valued by, participants. This method was also particularly suited to learning about healthcare problems and generating important solutions, thereby helping to bridge the gap between research and policy. Recruitment was carried out via purposive sampling, with the assistance of community pharmacies, general practices, various health agencies, government and non-government organisations. A total of 11 nominal groups were conducted; five groups consisted predominantly of consumers (n = 33 participants), two groups consisted predominantly of carers (n = 12 participants) and four were mixed groups, i.e. consumers, carers, and both (n = 26 participants).

Results

The findings suggested that to create a model of ideal healthcare for people with chronic conditions and their carers, appropriate and timely healthcare access was of paramount importance. Continuity and coordinated care, patient-centred care and affordability were equally the second most important healthcare priorities for all groups. When compared with other groups, access was discussed more frequently among participants residing in the rural area of Mount Isa. Compared to consumers, carers also discussed priorities that were more reminiscent with their caring roles, such as increased access and continuity and coordinated care.

Conclusions

Access to healthcare is the most important priority for people with chronic conditions and their carers. In the event of inappropriate access for certain groups, all other efforts to increase the quality of healthcare delivery, e.g. patient-centred care, may be pointless. However, health professionals alone may be limited in their ability to address the concerns related to healthcare access; structural changes by health policy makers may be needed.
Literature
1.
go back to reference World Health Organization. Health Systems: Improving Performance. In. Edited by The World Health Report 2000. Geneva: World Health Organization; 2000. p. 2000. World Health Organization. Health Systems: Improving Performance. In. Edited by The World Health Report 2000. Geneva: World Health Organization; 2000. p. 2000.
2.
go back to reference Greenhalgh T. Chronic illness: beyond the expert patient. BMJ British medical journal (International ed). 2009;338(7695):629–31. Greenhalgh T. Chronic illness: beyond the expert patient. BMJ British medical journal (International ed). 2009;338(7695):629–31.
3.
go back to reference Abelson J, Giacomini M, Lehoux P, Gauvin F-P. Bringing ‘the public’ into health technology assessment and coverage policy decisions: From principles to practice. Health policy. 2007;82(1):37–50.CrossRefPubMed Abelson J, Giacomini M, Lehoux P, Gauvin F-P. Bringing ‘the public’ into health technology assessment and coverage policy decisions: From principles to practice. Health policy. 2007;82(1):37–50.CrossRefPubMed
4.
go back to reference Mirzaei M, Aspin C, Essue B, Jeon YH, Dugdale P, Usherwood T, et al. A patient-centred approach to health service delivery: improving health outcomes for people with chronic illness. BMC health services research. 2013;13:251.CrossRefPubMedPubMedCentral Mirzaei M, Aspin C, Essue B, Jeon YH, Dugdale P, Usherwood T, et al. A patient-centred approach to health service delivery: improving health outcomes for people with chronic illness. BMC health services research. 2013;13:251.CrossRefPubMedPubMedCentral
5.
go back to reference Jowsey T, Jeon YH, Dugdale P, Glasgow NJ, Kljakovic M, Usherwood T. Challenges for co-morbid chronic illness care and policy in Australia: a qualitative study. Australia and New Zealand health policy. 2009;6:22.CrossRefPubMedPubMedCentral Jowsey T, Jeon YH, Dugdale P, Glasgow NJ, Kljakovic M, Usherwood T. Challenges for co-morbid chronic illness care and policy in Australia: a qualitative study. Australia and New Zealand health policy. 2009;6:22.CrossRefPubMedPubMedCentral
6.
go back to reference Sav A, Kendall E, McMillan SS, Kelly F, Whitty JA, King MA, et al. 'You say treatment, I say hard work': treatment burden among people with chronic illness and their carers in Australia. Health Soc Care Community. 2013;21(6):665–74.PubMed Sav A, Kendall E, McMillan SS, Kelly F, Whitty JA, King MA, et al. 'You say treatment, I say hard work': treatment burden among people with chronic illness and their carers in Australia. Health Soc Care Community. 2013;21(6):665–74.PubMed
7.
go back to reference Grol R, Wensing M, Mainz J, Ferreira P, Hearnshaw H, Hjortdahl P, et al. Patients' priorities with respect to general practice care: an international comparison. Family Practice. 1999;16(1):4–11.CrossRefPubMed Grol R, Wensing M, Mainz J, Ferreira P, Hearnshaw H, Hjortdahl P, et al. Patients' priorities with respect to general practice care: an international comparison. Family Practice. 1999;16(1):4–11.CrossRefPubMed
9.
go back to reference Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century, vol. 6. Washington, DC: National Academy Press; 2001. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century, vol. 6. Washington, DC: National Academy Press; 2001.
10.
go back to reference Britto MT, DeVellis RF, Hornung RW, DeFriese GH, Atherton HD, Slap GB. Health care preferences and priorities of adolescents with chronic illnesses. Pediatrics. 2004;114(5):1272(1279).CrossRef Britto MT, DeVellis RF, Hornung RW, DeFriese GH, Atherton HD, Slap GB. Health care preferences and priorities of adolescents with chronic illnesses. Pediatrics. 2004;114(5):1272(1279).CrossRef
11.
go back to reference Jung HP, Baerveldt C, Olesen F, Grol R, Wensing M. Patient characteristics as predictors of primary health care preferences: a systematic literature analysis. Health Expectations. 2003;6(2):160–81.CrossRefPubMed Jung HP, Baerveldt C, Olesen F, Grol R, Wensing M. Patient characteristics as predictors of primary health care preferences: a systematic literature analysis. Health Expectations. 2003;6(2):160–81.CrossRefPubMed
12.
go back to reference Sav A, King MA, Kelly F, McMillan SS, Kendall E, Whitty JA, et al. Self-management of chronic conditions in a rural and remote context. Australian Journal of Primary Health. 2013;21(1):90–5.CrossRef Sav A, King MA, Kelly F, McMillan SS, Kendall E, Whitty JA, et al. Self-management of chronic conditions in a rural and remote context. Australian Journal of Primary Health. 2013;21(1):90–5.CrossRef
13.
go back to reference Zucca A, Boyes A, Girgis A, Hall A, Newling G. Travelling all over the countryside: travel-related burden and financial difficulties reported by cancer patients in New South Wales and Victoria. Australian Journal of Rural Health. 2011;19(6):298–305.CrossRefPubMed Zucca A, Boyes A, Girgis A, Hall A, Newling G. Travelling all over the countryside: travel-related burden and financial difficulties reported by cancer patients in New South Wales and Victoria. Australian Journal of Rural Health. 2011;19(6):298–305.CrossRefPubMed
14.
go back to reference Winters CA, Cudney SA, Sullivan T, Thuesen A. The rural context and women's self-management of chronic health conditions. Chronic Illn. 2006;2(4):273–89.CrossRefPubMed Winters CA, Cudney SA, Sullivan T, Thuesen A. The rural context and women's self-management of chronic health conditions. Chronic Illn. 2006;2(4):273–89.CrossRefPubMed
15.
go back to reference Delbecq A, Van de Ven A, Gustafson D. Group Techniques for Program Planning: a guide to nominal group and delphi processes. USA: Scott, Foresman and Company; 1975. Delbecq A, Van de Ven A, Gustafson D. Group Techniques for Program Planning: a guide to nominal group and delphi processes. USA: Scott, Foresman and Company; 1975.
16.
go back to reference Gallagher M, Hares T, Spenser J, Bradshaw C, Webb I. The nominal group technique: a research tool for general practice? Family Practice. 1993;10(1):76–81.CrossRefPubMed Gallagher M, Hares T, Spenser J, Bradshaw C, Webb I. The nominal group technique: a research tool for general practice? Family Practice. 1993;10(1):76–81.CrossRefPubMed
17.
go back to reference McMillan SS, Kelly F, Sav A, Kendall E, King MA, Whitty JA, et al. Using the Nominal Group Technique: How to analyse across multiple groups. Health Serv Outcomes Res Method. 2014;14:92–108.CrossRef McMillan SS, Kelly F, Sav A, Kendall E, King MA, Whitty JA, et al. Using the Nominal Group Technique: How to analyse across multiple groups. Health Serv Outcomes Res Method. 2014;14:92–108.CrossRef
18.
go back to reference Drennan V, Walters K, Lenihan P, Cohen S, Myerson S, Iliffe S. Priorities in identifying unmet need in older people attending general practice: a nominal group technique study. Family Practice. 2007;24(5):454–60.CrossRefPubMed Drennan V, Walters K, Lenihan P, Cohen S, Myerson S, Iliffe S. Priorities in identifying unmet need in older people attending general practice: a nominal group technique study. Family Practice. 2007;24(5):454–60.CrossRefPubMed
20.
go back to reference Gonzales CK, Leroy C. Eliciting used requirements using appreciative inquiry. Empirical Software Engineering. 2011;16:733–72.CrossRef Gonzales CK, Leroy C. Eliciting used requirements using appreciative inquiry. Empirical Software Engineering. 2011;16:733–72.CrossRef
21.
go back to reference Van Breda AD. Steps to analysing multiple-group NGT data. Soc Work Practitioner-Researcher. 2005;17(1):1–14. Van Breda AD. Steps to analysing multiple-group NGT data. Soc Work Practitioner-Researcher. 2005;17(1):1–14.
22.
go back to reference Gulliford M, Figueroa-Munoz J, Morgan M, Hughes D, Gibson B, Beech R, et al. What does 'access to health care' mean? Journal of Health Services Research & Policy. 2002;7(3):186–8.CrossRef Gulliford M, Figueroa-Munoz J, Morgan M, Hughes D, Gibson B, Beech R, et al. What does 'access to health care' mean? Journal of Health Services Research & Policy. 2002;7(3):186–8.CrossRef
23.
24.
go back to reference Sav A, King MA, Whitty JA, Kendall E, McMillan SS, Kelly F, et al. Burden of treatment for chronic illness: a concept analysis and review of the literature. Health Expectations. 2013;31:2013. doi:10.1111/hex.12046. Epub ahead of print Jan. Sav A, King MA, Whitty JA, Kendall E, McMillan SS, Kelly F, et al. Burden of treatment for chronic illness: a concept analysis and review of the literature. Health Expectations. 2013;31:2013. doi:10.​1111/​hex.​12046. Epub ahead of print Jan.
25.
go back to reference Ehrlich C, Kendall E, Muenchberger H, Armstrong K. Coordinated care: what does that really mean? Health Soc Care Community. 2009;17(6):619–27.CrossRefPubMed Ehrlich C, Kendall E, Muenchberger H, Armstrong K. Coordinated care: what does that really mean? Health Soc Care Community. 2009;17(6):619–27.CrossRefPubMed
26.
go back to reference Sanderson T, Hewlett S, Richards P, Morris M, Calnan M. Utilizing Qualitative Data from Nominal Groups: Exploring the Influences on Treatment Outcome Prioritization with Rheumatoid Arthritis Patients. Journal of Health Psychology. 2012;17(1):132–42.CrossRefPubMed Sanderson T, Hewlett S, Richards P, Morris M, Calnan M. Utilizing Qualitative Data from Nominal Groups: Exploring the Influences on Treatment Outcome Prioritization with Rheumatoid Arthritis Patients. Journal of Health Psychology. 2012;17(1):132–42.CrossRefPubMed
Metadata
Title
The ideal healthcare: priorities of people with chronic conditions and their carers
Authors
Adem Sav
Sara S. McMillan
Fiona Kelly
Michelle A. King
Jennifer A. Whitty
Elizabeth Kendall
Amanda J. Wheeler
Publication date
01-06-2015
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2015
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-015-1215-3

Other articles of this Issue 1/2015

BMC Health Services Research 1/2015 Go to the issue