Primary Healthcare Organization and Quality-of-Life Outcomes for Persons with Chronic Disease.
OBJECTIVE
To explore the association between primary healthcare (PHC) organizational model and health-related quality of life (HRQoL) in persons with chronic disease.


METHODS
We recruited 776 patients with a primary diagnosis of one of four chronic diseases from 33 PHC clinics. Patients were interviewed at baseline, 6, 12 and 18 months. We categorized PHC model by administrative type and by a taxonomy according to organizational attributes. HRQoL was measured by disease-specific questionnaires.


RESULTS
Mean age was 67 years and 55.3% were female. PHC models differed with respect to case mix: community models served older patients with higher co-morbidity and lower health status. Multilevel logistic regression revealed that none of the PHC organizational models was associated with HRQoL. Having fewer co-morbidities, higher self-rated health and not using home care services were associated with higher HRQoL.


CONCLUSIONS
Despite their having patients with more complex health problems, HRQoL in patients of community practices was equivalent to that of patients in other types of PHC organizations.
Institut national de santé publique du Québec and Direction de santé publique de Montréal, Professor, Université de Montréal, Montreal, QC.
Debbie Ehrmann
DE
Feldman
Jean-Frédéric
JF
Lévesque
Valérie
V
Lemieux
André
A
Tourigny
Jean-Pierre
JP
Lavoie
Pierre
P
Tousignant