title: Improving chronic illness care: translating evidence into action.
abstract: The growing number of persons suffering from major chronic illnesses face many obstacles in coping with their condition, not least of which is medical care that often does not meet their needs for effective clinical management, psychological support, and information. The primary reason for this may be the mismatch between their needs and care delivery systems largely designed for acute illness. Evidence of effective system changes that improve chronic care is mounting. We have tried to summarize this evidence in the Chronic Care Model (CCM) to guide quality improvement. In this paper we describe the CCM, its use in intensive quality improvement activities with more than 100 health care organizations, and insights gained in the process.
authors.affiliation: W.A. MacColl Institute for Healthcare Innovation at the Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, USA.
authors.forename: E H
authors.initials: EH
authors.lastname: Wagner
authors.forename: B T
authors.initials: BT
authors.lastname: Austin
authors.forename: C
authors.initials: C
authors.lastname: Davis
authors.forename: M
authors.initials: M
authors.lastname: Hindmarsh
authors.forename: J
authors.initials: J
authors.lastname: Schaefer
authors.forename: A
authors.initials: A
authors.lastname: Bonomi
mesh_terms: D002908:Chronic Disease / Q000628:therapy*; D019317:Evidence-Based Medicine; D006301:Health Services Needs and Demand; D006801:Humans; D011785:Quality Assurance, Health Care; D012648:Self Care; D014481:United States