Finding common ground: patient-centeredness and evidence-based chronic illness care.
Health outcomes for patients with major chronic illnesses depend on the appropriate use of proven pharmaceuticals and other therapeutic technologies, and effective self-management by patients. Effective chronic illness care then bases clinical decisions on the best, rigorous scientific evidence, or evidence-based medicine. Effective support for patient self-management includes efforts to increase patient participation in care and collaborative goal-setting and planning of treatment. These interventions appear somewhat consistent with recent conceptualizations of patient-centered care. The consistent delivery of proven therapies and information and support for self-management requires practice systems organized for that purpose. The Chronic Care Model is a compilation of those practice system changes shown to improve chronic care. This paper explores the concept of patient-centeredness and its relationship to the Chronic Care Model. We conclude that the Model is both evidence-based and patient-centered and that these can be properties of health systems, and not just of individual practitioners.
Wagner
Edward H
EH
MacColl Institute for Healthcare Innovation, Center for Health Studies, Group Health Cooperative, Seattle, WA, USA. wagner.e@ghc.org
Bennett
Susan M
SM
Austin
Brian T
BT
Greene
Sarah M
SM
Schaefer
Judith K
JK
Vonkorff
Michael
M
D002908:Chronic Disease / Q000628:therapy*; D019317:Evidence-Based Medicine; D006266:Health Education / Q000458:organization & administration*; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D017146:Models, Organizational; D010347:Patient Care Planning / Q000458:organization & administration*; D010358:Patient Participation; D018802:Patient-Centered Care / Q000458:organization & administration*; D011787:Quality of Health Care / Q000458:organization & administration; D014481:United States