Quality of care for chronic illnesses.
OBJECTIVE
The purpose of this paper is to discover the extent to which evidence-based practices and computer systems for managing chronic illness are used within Swedish primary health care.


METHODS
The methodology was a replication of a similar national USA survey study and an interview study.


RESULTS
The findings show large variations and an under-use of a number of evidence-based care management practices and of IT for managing depression, heart disease, asthma, and diabetes in Sweden. Follow-up interview studies with heads of primary care centres gathered their views about the factors which helped and hindered improving care and prevention for these patient groups.


CONCLUSIONS
The study data identify actions which would significantly improve the quality of care for people suffering from chronic illnesses. Effective prevention and management of chronic illness in primary care can reduce unnecessary patient suffering and lower costs of care.


CONCLUSIONS
Evidence of effective methods for managing these illnesses has been reported, but it is not known how widely these methods or information technology are used in primary care outside the USA. The paper gives the first comprehensive nation-wide data on the use of evidence-based practices and computer systems for managing chronic illness in primary care in a European public health care system. It provides information allowing targeted actions which would improve quality of care which are low cost and high cost saving in the long term.
Ovretveit
John
J
Karolinska Institute Medical Management Centre, Stockholm, Sweden. jovret@aol.com
Gillies
Robin
R
Rundall
Thomas G
TG
Shortell
Stephen M
SM
Brommels
Mats
M
D002908:Chronic Disease / Q000628:therapy*; D003142:Communication; D019317:Evidence-Based Medicine; D019983:Guideline Adherence; D006302:Health Services Research; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000458:organization & administration*; D011322:Primary Prevention / Q000458:organization & administration; D011787:Quality of Health Care / Q000458:organization & administration*; D017010:Reminder Systems; D013548:Sweden