Abstract
This study was conducted to (1) identify improvements in care quality and well-being of patients with chronic obstructive pulmonary disease in the Netherlands and (2) investigate the longitudinal relationship between these factors. This longitudinal study was conducted among patients diagnosed with chronic obstructive pulmonary disease enrolled in the Kennemer Lucht care programme in the Netherlands. Biomarker data (lung capacity) were collected at patients' health care practices in 2012. Complete case analysis was conducted, and the multiple imputation technique allowed us to report pooled results from imputed datasets. Surveys were filled out by 548/1303 (42%) patients at T0 (2012) and 569/996 (57%) remaining participants at T1. Quality of care improved significantly (p < 0.05). Analyses adjusted for well-being at T0, age, educational level, marital status, gender, lung function and health behaviours showed that patients' assessments of the quality of chronic care delivery at T0 (p < 0.01) and changes therein (p < 0.001) predicted patients' well-being at T1. These results clearly show that the quality of care and changes therein are important for the well-being of patients with chronic obstructive pulmonary disease in the primary care setting. To improve quality of care for chronically ill patients, multicomponent interventions may be needed.
Highlights
Populations are ageing worldwide and the prevalence of chronic diseases is increasing rapidly [1]
We identified a cross-sectional relationship between the quality of chronic care delivery and the well-being of patients with chronic obstructive pulmonary disease [27], but the longitudinal relationship between these factors in the primary care setting remains unknown
This study showed that multicomponent interventions based on the chronic care model improved patients’ experiences with the quality of chronic care delivery in the primary care setting over time
Summary
Populations are ageing worldwide and the prevalence of chronic diseases is increasing rapidly [1]. Chronic obstructive pulmonary disease is the leading cause of death from lung disease worldwide [2]. International Journal of Integrated Care – Volume 15, 22 June – URN:NBN:NL:UI:10-1-114833 – http://www.ijic.org/. The prevalence of chronic obstructive pulmonary disease among older adults (aged ≥ 55 years) is about 12% [4]. Due to patients’ substantial contributions to the volumes of emergency department visits and hospitalizations, chronic obstructive pulmonary disease is considered a costly disease [5]. It negatively affects patients’ wellbeing, imposing a burden on daily life that extends beyond their physical/health conditions [6,7]
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