Alignment of patient and primary care practice member perspectives of chronic illness care: a cross-sectional analysis

dc.creatorNoel, Pollyen
dc.creatorParchman, Michael L.en
dc.creatorPalmer, Ray F.en
dc.creatorRomer, Raquel L.en
dc.creatorLeykum, Luci K.en
dc.creatorLanham, Holly J.en
dc.creatorZeber, John E.en
dc.creatorBowers, Krista W.en
dc.descriptionPolly H. Noel and Luci K. Leykum are with the South Texas Veterans Health Care System, 7400 Merton Minter Blvd, San Antonio, TX 78229, USA -- Polly H. Noel, Ray F. Palmer, Raquel L. Romero, Luci K. Leykum, Holly J. Lanham, and Krista W. Bowers are with the Department of Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229, USA -- Michael L. Parchman is with the MacColl Center for Healthcare Innovation, Group Health Research Institute, Group Health Cooperative, 1730 Minor Ave 1600, Seattle, WA 98101, USA -- Holly J. Leykum is with the The McCombs School of Business, The University of Texas at Austin, 2110 Speedway, Stop B6000, Austin, TX 78712, USA -- John E. Zeber is with the Central Texas Veterans Health Care System, 1901 S. 1st St, Temple, TX 76504, USA and Scott and White Healthcare Center for Applied Health Research, 2401 S. 31st St, Temple, TX 76508, USAen
dc.description.abstractBackground: Little is known as to whether primary care teams’ perceptions of how well they have implemented the Chronic Care Model (CCM) corresponds with their patients’ own experience of chronic illness care. We examined the extent to which practice members’ perceptions of how well they organized to deliver care consistent with the CCM were associated with their patients’ perceptions of the chronic illness care they have received. Methods: Analysis of baseline measures from a cluster randomized controlled trial testing a practice facilitation intervention to implement the CCM in small, community-based primary care practices. All practice “members” (i.e., physician providers, non-physician providers, and staff) completed the Assessment of Chronic Illness Care (ACIC) survey and adult patients with 1 or more chronic illnesses completed the Patient Assessment of Chronic Illness Care (PACIC) questionnaire. Results: Two sets of hierarchical linear regression models accounting for nesting of practice members (N = 283) and patients (N = 1,769) within 39 practices assessed the association between practice member perspectives of CCM implementation (ACIC scores) and patients’ perspectives of CCM (PACIC). ACIC summary score was not significantly associated with PACIC summary score or most of PACIC subscale scores, but four of the ACIC subscales were consistently associated with PACIC summary score and the majority of PACIC subscale scores after controlling for patient characteristics. The magnitude of the coefficients, however, indicates that the level of association is weak. Conclusions: The ACIC and PACIC scales appear to provide complementary and relatively unique assessments of how well clinical services are aligned with the CCM. Our findings underscore the importance of assessing both patient and practice member perspectives when evaluating quality of chronic illness care.en
dc.description.departmentInformation, Risk, and Operations Management (IROM)en
dc.identifier.citationNoël, Polly H., Michael L. Parchman, Ray F. Palmer, Raquel L. Romero, Luci K. Leykum, Holly J. Lanham, John E. Zeber, and Krista W. Bowers. “Alignment of Patient and Primary Care Practice Member Perspectives of Chronic Illness Care: A Cross-Sectional Analysis.” BMC Family Practice 15, no. 1 (March 29, 2014): 57. doi:10.1186/1471-2296-15-57.en
dc.publisherBMC Family Practiceen
dc.rightsAdministrative deposit of works to UT Digital Repository: This works author(s) is or was a University faculty member, student or staff member; this article is already available through open access at The public license is specified as CC-BY: The library makes the deposit as a matter of fair use (for scholarly, educational, and research purposes), and to preserve the work and further secure public access to the works of the University.en
dc.subjectchronic painen
dc.subjectprimary careen
dc.subjectpatient surveysen
dc.titleAlignment of patient and primary care practice member perspectives of chronic illness care: a cross-sectional analysisen

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