title: Patients' experience of chronic illness care in a network of teaching settings.
abstract: OBJECTIVE
  To evaluate chronic illness care delivery from the patient's perspective and to examine its main correlates.
  
  
  METHODS
  Cross-sectional, descriptive study using questionnaires and medical chart review.
  
  
  METHODS
  Nine teaching family practices in Quebec.
  
  
  METHODS
  A total of 364 patients with diabetes, hypertension, or chronic obstructive pulmonary disease.
  
  
  METHODS
  Score on the Patient Assessment of Chronic Illness Care (PACIC) questionnaire, which evaluates the patient's perspective on the care received based on the chronic care model (CCM); patients characteristics (sex, level of education, number of chronic illnesses); patient-physician relationship (relational continuity, interpersonal communication assessed from the patient's perspective); and interdisciplinary care and technical quality of care abstracted from patients' medical charts.
  
  
  RESULTS
  The mean PACIC score obtained (2.8 out of 5) indicates that, on average, CCM-concordant care "generally did not occur" or occurred only "sometimes" in this network of teaching practices. However, with a mean technical quality-of-care score of nearly 80%, physicians in this network showed a high degree of adherence to clinical guidelines for the chronic illnesses under study. Patient education level lower than high school was negatively associated with PACIC scores, while positive associations were found with male sex, number of chronic illnesses, relational continuity, interpersonal communication, interdisciplinary care, and technical quality of care.
  
  
  CONCLUSIONS
  Patients with less education reported receiving less CCM-concordant care. The patient-physician relationship was the strongest correlate of PACIC scores, while interdisciplinary care and technical quality of care had modest contributions.
authors.affiliation: Department of Psychology, Université du Québec à Montréal, PO Box 8888, Station Centre-ville, Montreal, QC H3C 3P8. houle.janie@uqam.ca
authors.forename: Janie
authors.initials: J
authors.lastname: Houle
authors.forename: Marie-Dominique
authors.initials: MD
authors.lastname: Beaulieu
authors.forename: Marie-Thérèse
authors.initials: MT
authors.lastname: Lussier
authors.forename: Claudio
authors.initials: C
authors.lastname: Del Grande
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Pellerin
authors.forename: Marie
authors.initials: M
authors.lastname: Authier
authors.forename: Réjean
authors.initials: R
authors.lastname: Duplain
authors.forename: Tri Minh
authors.initials: TM
authors.lastname: Tran
authors.forename: François
authors.initials: F
authors.lastname: Allison
mesh_terms: D000368:Aged; D001294:Attitude to Health; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D004522:Educational Status; D005194:Family Practice / Q000193:education / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D033183:Interdisciplinary Communication; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010348:Patient Care Team; D018802:Patient-Centered Care / Q000592:standards* / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000592:standards* / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D011792:Quebec; D011795:Surveys and Questionnaires