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BMC Health Services Research
Published in: BMC Health Services Research 1/2009

Open Access 01-12-2009 | Research article

Structured chronic primary care and health-related quality of life in chronic heart failure

Authors: Marije Bosch, Trudy van der Weijden, Richard Grol, Henk Schers, Reinier Akkermans, Louis Niessen, Michel Wensing

Published in: BMC Health Services Research | Issue 1/2009

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Abstract

Background

Structured care is proposed as a lever for improving care for patients with chronic conditions. The purpose of this study was to explore the associations of structured care characteristics, derived from the Chronic Care Model, with health-related quality of life (HRQOL) and optimal clinical management in chronic heart failure (CHF) patients in primary care, as well as the association between optimal management and HRQOL.

Methods

Cross-sectional observational study using multi-level random-coefficient analyses of a representative sample of 357 patients diagnosed with CHF from 42 primary care practices in the Netherlands. We combined individual medical record data with patient and physician questionnaires.

Results

There was large variation in the levels and presence of structured care elements. A 91% of physicians indicated that next appointments for CHF patients were made immediately after visits, while 11% indicated that reminders on CHF management were periodically received in their practice. Few associations were found between the organizational characteristics and optimal treatment or HRQOL. Optimal pharmacological treatment related to better quality of life (β = -11.5, P < .0001). Also, more lifestyle advice was given in practices with an appointment system allowing contact with more than one professional during the encounter (β = 1.0, P = .04).

Conclusion

HRQOL and treatment quality in CHF patients were not consistently associated with characteristics of structured care in primary care practices.
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Metadata
Title
Structured chronic primary care and health-related quality of life in chronic heart failure
Authors
Marije Bosch
Trudy van der Weijden
Richard Grol
Henk Schers
Reinier Akkermans
Louis Niessen
Michel Wensing
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2009
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-9-104

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