Assessment of Chronic Illness Care with the German version of the ACIC in different primary care settings in Switzerland

Claudia Steurer-Stey,Thomas Rosemann,Anja Frei,Sibylle Malcolm-Kohler,Marco Zoller,Gabriela Schmid-Mohler

doi:10.1186/1477-7525-8-122

Claudia Steurer-Stey, Thomas Rosemann + Show 4 more

Open Access

https://doi.org/10.1186/1477-7525-8-122

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Abstract

BackgroundIn Switzerland the extent to which patients with chronic illnesses receive care congruent with the Chronic Care Model (CCM) is unknown.MethodsAccording to guidelines we translated the Assessment of Chronic Illness Care (ACIC) into German (G-ACIC). We tested the instrument in different primary care settings and compared subscales with the original testing.ResultsDifficulties encountered during the translation process consisted in the difference of health care settings in Switzerland and USA. However initial testing showed the G-ACIC to be a suitable instrument. The average ACIC subscale scores in Swiss managed care (MC)-, group (GP)- and single handed practices (SP) were higher for MC practices than for group- and single handed practices: Organization of the healthcare delivery system: MC mean (m) = 6.80 (SD 1.55), GP m = 5.42 (SD 0.99), SP m = 4.60 (SD 2.07); community linkages: MC m = 4.19 (SD 1.47), GP m = 4.83 (SD 1.81), SP m = 3.10 (SD 2.12); self-management support: MC m = 4.96 (SD 1.13), GP m = 4.73 (SD 1.40), SP m = 4.43 (SD 1.34); decision support: MC m = 4.75 (SD 1.06); GP m = 4.20 (SD 0.87), SP m = 3.25 (SD 1.59); delivery system design: MC m = 5.98 (SD 1.61), GP m = 5.05 (SD 2.05), SP m = 3.86 (SD 1.51) and clinical information systems: MC m = 4.34 (SD = 2.49), GP m = 2.06 (SD 1.35), SP m = 3.20 (SD 1.57).ConclusionsThe G-ACIC is applicable and useful for comparing different health care settings in German speaking countries. Managed care organizations seem to implement the different components of the CCM in a greater extend than group and single handed practices. However, much room exists for further improvement.

Highlights

The Assessment of Chronic Illness Care (ACIC) questionnaire was developed to assess if provided care is in alignment with the Chronic Care Model (CCM) [1]
Managed care organizations seem to implement the different components of the CCM in a greater extend than group and single handed practices
The ACIC aims at organizational teams to help them to identify areas for improvement for chronic illness care and to evaluate the level and nature of improvements made in their system

Summary

Results

The Swiss managed care (MC) organizations showed better results in most subscales compared to the group practices and single handed practices. The score for health care organization was higher (6.80 vs 6.42), whereas for the community linkages (4.19 vs 5.90) and self-management areas (4.96 vs 5.41) lower scores were obtained (Table 1). The group practices and single handed practices scored lower in all subscales compared to the baseline scores of the original testing. The group practices showed for five of the six chronic care model elements only basic support and regarding information systems limited support for patients with diabetes. The subscale scores for the single handed practices were below the group practices with the exception of the information systems element (Table 1)

Conclusions

Introduction

Methods

Discussion

Conclusion