Achievement of appropriate self-care. Does care delivery system make a difference?
OBJECTIVE
The purpose of this article is to review the evidence linking variations in care delivery system with achievement of appropriate self-care.


METHODS
This synthetic review of the research literature used the Outcomes Model for Health Care Research. The concept of self-care was reviewed from several theoretical perspectives, as was the quality of instruments used to measure aspects of self-care. Finally, studies examining the linkage between care delivery system and self-care were critically analyzed.


RESULTS
Reliable and valid instruments exist to measure self-care agency and self-care performance, and these data elements are collected routinely in many care settings. Only a few studies, however, have examined the relation between achievement of self-care and variations in delivery systems.


CONCLUSIONS
Achievement of appropriate self-care may be an outcome measure better suited to nonacute care settings or across the continuum of care. Additionally, work is needed in applying risk-adjustment strategies to the measurement of achievement of appropriate self-care.
Henry
S B
SB
Department of Community Health Systems, University of California, San Francisco 94143-0608, USA.
Holzemer
W L
WL
D000203:Activities of Daily Living; D003695:Delivery of Health Care / Q000458:organization & administration*; D006302:Health Services Research / Q000379:methods; D006801:Humans; D008134:Long-Term Care; D008962:Models, Theoretical; D017063:Outcome Assessment, Health Care / Q000379:methods*; D012648:Self Care