title: System supports for chronic illness care and their relationship to clinical outcomes.
abstract: The Chronic Care Model proposes that organizational system changes improve the quality of chronic care. This cross-sectional study explores the relationship between system supports for chronic care and clinical outcomes for two major chronic illnesses: diabetes and cardiovascular disease. Nine community-based primary care practices from the Practice Partner Research Network (PPRNet) are studied using practice group interviews and clinical data from the PPRNet database. As overall system support increases, providers' achievement of recommended care and desirable patient outcomes improves (r = .828, p = .006). Enhanced systems for provider decision support had the strongest positive correlation with clinical outcomes (r = .907, p = .001).
authors.affiliation: Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
authors.forename: C
authors.initials: C
authors.lastname: Feifer
authors.forename: S M
authors.initials: SM
authors.lastname: Ornstein
authors.forename: P J
authors.initials: PJ
authors.lastname: Nietert
authors.forename: R G
authors.initials: RG
authors.lastname: Jenkins
mesh_terms: D019985:Benchmarking / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000628:therapy; D002908:Chronic Disease / Q000628:therapy*; D003430:Cross-Sectional Studies; D020000:Decision Support Systems, Clinical; D003920:Diabetes Mellitus / Q000628:therapy; D019468:Disease Management; D006801:Humans; D011320:Primary Health Care / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000379:methods*; D013022:South Carolina