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. 2004 Aug;13(4):299–305. doi: 10.1136/qshc.2004.010744

Improving the quality of health care for chronic conditions

J Epping-Jordan 1, S Pruitt 1, R Bengoa 1, E Wagner 1
PMCID: PMC1743863  PMID: 15289634

Abstract



 Chronic conditions are increasingly the primary concern of healthcare systems throughout the world. In response to this challenge, the World Health Organization has joined with the MacColl Institute for Healthcare Innovation to adapt the Chronic Care Model (CCM) from a global perspective. The resultant effort is the Innovative Care for Chronic Conditions (ICCC) framework which expands community and policy aspects of improving health care for chronic conditions and includes components at the micro (patient and family), meso (healthcare organisation and community), and macro (policy) levels. The framework provides a flexible but comprehensive base on which to build or redesign health systems in accordance with local resources and demands.

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Selected References

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  1. Abramson W. B. Monitoring and evaluation of contracts for health service delivery in Costa Rica. Health Policy Plan. 2001 Dec;16(4):404–411. doi: 10.1093/heapol/16.4.404. [DOI] [PubMed] [Google Scholar]
  2. Anderson Gerard F. Physician, public, and policymaker perspectives on chronic conditions. Arch Intern Med. 2003 Feb 24;163(4):437–442. doi: 10.1001/archinte.163.4.437. [DOI] [PubMed] [Google Scholar]
  3. Barr Victoria J., Robinson Sylvia, Marin-Link Brenda, Underhill Lisa, Dotts Anita, Ravensdale Darlene, Salivaras Sandy. The expanded Chronic Care Model: an integration of concepts and strategies from population health promotion and the Chronic Care Model. Hosp Q. 2003;7(1):73–82. doi: 10.12927/hcq.2003.16763. [DOI] [PubMed] [Google Scholar]
  4. Beattie A., Kalk W. J., Price M., Rispel L., Broomberg J., Cabral J. The management of diabetes at primary level in South Africa: the results of a facility-based assessment. J R Soc Promot Health. 1998 Dec;118(6):338–345. doi: 10.1177/146642409811800612. [DOI] [PubMed] [Google Scholar]
  5. Becher E. C., Chassin M. R. Improving the quality of health care: who will lead? Health Aff (Millwood) 2001 Sep-Oct;20(5):164–179. doi: 10.1377/hlthaff.20.5.164. [DOI] [PubMed] [Google Scholar]
  6. Blendon R. J., Schoen C., Donelan K., Osborn R., DesRoches C. M., Scoles K., Davis K., Binns K., Zapert K. Physicians' views on quality of care: a five-country comparison. Health Aff (Millwood) 2001 May-Jun;20(3):233–243. doi: 10.1377/hlthaff.20.3.233. [DOI] [PubMed] [Google Scholar]
  7. Blendon Robert J., Schoen Cathy, DesRoches Catherine, Osborn Robin, Zapert Kinga. Common concerns amid diverse systems: health care experiences in five countries. Health Aff (Millwood) 2003 May-Jun;22(3):106–121. doi: 10.1377/hlthaff.22.3.106. [DOI] [PubMed] [Google Scholar]
  8. Bodenheimer Thomas, Lorig Kate, Holman Halsted, Grumbach Kevin. Patient self-management of chronic disease in primary care. JAMA. 2002 Nov 20;288(19):2469–2475. doi: 10.1001/jama.288.19.2469. [DOI] [PubMed] [Google Scholar]
  9. Bodenheimer Thomas, Wagner Edward H., Grumbach Kevin. Improving primary care for patients with chronic illness: the chronic care model, Part 2. JAMA. 2002 Oct 16;288(15):1909–1914. doi: 10.1001/jama.288.15.1909. [DOI] [PubMed] [Google Scholar]
  10. Clark Noreen M. Management of chronic disease by patients. Annu Rev Public Health. 2001 Nov 6;24:289–313. doi: 10.1146/annurev.publhealth.24.100901.141021. [DOI] [PubMed] [Google Scholar]
  11. Coleman R., Gill G., Wilkinson D. Noncommunicable disease management in resource-poor settings: a primary care model from rural South Africa. Bull World Health Organ. 1998;76(6):633–640. [PMC free article] [PubMed] [Google Scholar]
  12. Epping-Jordan JoAnne E., Ludman Evette J. Disseminating health care innovation. JAMA. 2003 Sep 17;290(11):1455–1456. doi: 10.1001/jama.290.11.1455-b. [DOI] [PubMed] [Google Scholar]
  13. Farmer P., Léandre F., Mukherjee J. S., Claude M., Nevil P., Smith-Fawzi M. C., Koenig S. P., Castro A., Becerra M. C., Sachs J. Community-based approaches to HIV treatment in resource-poor settings. Lancet. 2001 Aug 4;358(9279):404–409. doi: 10.1016/s0140-6736(01)05550-7. [DOI] [PubMed] [Google Scholar]
  14. Glasgow Russell E., Funnell Martha M., Bonomi Amy E., Davis Connie, Beckham Valerie, Wagner Edward H. Self-management aspects of the improving chronic illness care breakthrough series: implementation with diabetes and heart failure teams. Ann Behav Med. 2002 Spring;24(2):80–87. doi: 10.1207/S15324796ABM2402_04. [DOI] [PubMed] [Google Scholar]
  15. Guevara James P., Wolf Fredric M., Grum Cyril M., Clark Noreen M. Effects of educational interventions for self management of asthma in children and adolescents: systematic review and meta-analysis. BMJ. 2003 Jun 14;326(7402):1308–1309. doi: 10.1136/bmj.326.7402.1308. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Gulliford M. C., Alert C. V., Mahabir D., Ariyanayagam-Baksh S. M., Fraser H. S., Picou D. I. Diabetes care in middle-income countries: a Caribbean case study. Diabet Med. 1996 Jun;13(6):574–581. doi: 10.1002/(SICI)1096-9136(199606)13:6<574::AID-DIA113>3.0.CO;2-C. [DOI] [PubMed] [Google Scholar]
  17. Kitahata Mari M., Tegger Mary K., Wagner Edward H., Holmes King K. Comprehensive health care for people infected with HIV in developing countries. BMJ. 2002 Oct 26;325(7370):954–957. doi: 10.1136/bmj.325.7370.954. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Kravitz Richard L., Bell Robert A., Azari Rahman, Kelly-Reif Steven, Krupat Edward, Thom David H. Direct observation of requests for clinical services in office practice: what do patients want and do they get it? Arch Intern Med. 2003 Jul 28;163(14):1673–1681. doi: 10.1001/archinte.163.14.1673. [DOI] [PubMed] [Google Scholar]
  19. Lewis Richard, Dixon Jennifer. Rethinking management of chronic diseases. BMJ. 2004 Jan 24;328(7433):220–222. doi: 10.1136/bmj.328.7433.220. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Lorig K. R., Ritter P., Stewart A. L., Sobel D. S., Brown B. W., Jr, Bandura A., Gonzalez V. M., Laurent D. D., Holman H. R. Chronic disease self-management program: 2-year health status and health care utilization outcomes. Med Care. 2001 Nov;39(11):1217–1223. doi: 10.1097/00005650-200111000-00008. [DOI] [PubMed] [Google Scholar]
  21. Norris S. L., Engelgau M. M., Narayan K. M. Effectiveness of self-management training in type 2 diabetes: a systematic review of randomized controlled trials. Diabetes Care. 2001 Mar;24(3):561–587. doi: 10.2337/diacare.24.3.561. [DOI] [PubMed] [Google Scholar]
  22. Norris Susan L., Lau Joseph, Smith S. Jay, Schmid Christopher H., Engelgau Michael M. Self-management education for adults with type 2 diabetes: a meta-analysis of the effect on glycemic control. Diabetes Care. 2002 Jul;25(7):1159–1171. doi: 10.2337/diacare.25.7.1159. [DOI] [PubMed] [Google Scholar]
  23. Nsutebu E. F., Walley J. D., Mataka E., Simon C. F. Scaling-up HIV/AIDS and TB home-based care: lessons from Zambia. Health Policy Plan. 2001 Sep;16(3):240–247. doi: 10.1093/heapol/16.3.240. [DOI] [PubMed] [Google Scholar]
  24. Raheja B. S., Kapur A., Bhoraskar A., Sathe S. R., Jorgensen L. N., Moorthi S. R., Pendsey S., Sahay B. K. DiabCare Asia--India Study: diabetes care in India--current status. J Assoc Physicians India. 2001 Jul;49:717–722. [PubMed] [Google Scholar]
  25. Setel Philip W., Saker Lance, Unwin Nigel C., Hemed Yusuf, Whiting David R., Kitange Henry. Is it time to reassess the categorization of disease burdens in low-income countries? Am J Public Health. 2004 Mar;94(3):384–388. doi: 10.2105/ajph.94.3.384. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Vladeck B. C. You can't get there from here: obstacles to improving care of the chronically ill. Health Aff (Millwood) 2001 Nov-Dec;20(6):175–179. doi: 10.1377/hlthaff.20.6.175. [DOI] [PubMed] [Google Scholar]
  27. Wagner E. H., Austin B. T., Davis C., Hindmarsh M., Schaefer J., Bonomi A. Improving chronic illness care: translating evidence into action. Health Aff (Millwood) 2001 Nov-Dec;20(6):64–78. doi: 10.1377/hlthaff.20.6.64. [DOI] [PubMed] [Google Scholar]
  28. Wagner E. H., Davis C., Schaefer J., Von Korff M., Austin B. A survey of leading chronic disease management programs: are they consistent with the literature? Manag Care Q. 1999 Summer;7(3):56–66. [PubMed] [Google Scholar]
  29. Wagner E. H. The role of patient care teams in chronic disease management. BMJ. 2000 Feb 26;320(7234):569–572. doi: 10.1136/bmj.320.7234.569. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Wang P. S., Berglund P., Kessler R. C. Recent care of common mental disorders in the United States : prevalence and conformance with evidence-based recommendations. J Gen Intern Med. 2000 May;15(5):284–292. doi: 10.1046/j.1525-1497.2000.9908044.x. [DOI] [PMC free article] [PubMed] [Google Scholar]

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