Assessment of Chronic Illness Care with the German version of the ACIC in different primary care settings in Switzerland.
BACKGROUND
In Switzerland the extent to which patients with chronic illnesses receive care congruent with the Chronic Care Model (CCM) is unknown.


METHODS
According to guidelines we translated the Assessment of Chronic Illness Care (ACIC) into German (G-ACIC). We tested the instrument in different primary care settings and compared subscales with the original testing.


RESULTS
Difficulties encountered during the translation process consisted in the difference of health care settings in Switzerland and USA. However initial testing showed the G-ACIC to be a suitable instrument. The average ACIC subscale scores in Swiss managed care (MC)-, group (GP)- and single handed practices (SP) were higher for MC practices than for group- and single handed practices: Organization of the healthcare delivery system: MC mean (m) = 6.80 (SD 1.55), GP m = 5.42 (SD 0.99), SP m = 4.60 (SD 2.07); community linkages: MC m = 4.19 (SD 1.47), GP m = 4.83 (SD 1.81), SP m = 3.10 (SD 2.12); self-management support: MC m = 4.96 (SD 1.13), GP m = 4.73 (SD 1.40), SP m = 4.43 (SD 1.34); decision support: MC m = 4.75 (SD 1.06); GP m = 4.20 (SD 0.87), SP m = 3.25 (SD 1.59); delivery system design: MC m = 5.98 (SD 1.61), GP m = 5.05 (SD 2.05), SP m = 3.86 (SD 1.51) and clinical information systems: MC m = 4.34 (SD = 2.49), GP m = 2.06 (SD 1.35), SP m = 3.20 (SD 1.57).


CONCLUSIONS
The G-ACIC is applicable and useful for comparing different health care settings in German speaking countries. Managed care organizations seem to implement the different components of the CCM in a greater extend than group and single handed practices. However, much room exists for further improvement.
Steurer-Stey
Claudia
C
Department of General Practice and Health Services Research, University of Zurich, University Hospital of Zurich, Sonneggstrasse 6, CH-8091 Zürich, Switzerland. claudia.stey@usz.ch
Frei
Anja
A
Schmid-Mohler
Gabriela
G
Malcolm-Kohler
Sibylle
S
Zoller
Marco
M
Rosemann
Thomas
T
D002908:Chronic Disease / Q000628:therapy*; D005858:Germany; D006801:Humans; D007802:Language; D010043:Outcome and Process Assessment, Health Care; D011594:Psychometrics; D011787:Quality of Health Care / Q000592:standards*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013557:Switzerland; D014175:Translating