title: The potential for integrated care programmes to improve quality of care as assessed by patients with COPD: early results from a real-world implementation study in The Netherlands.
abstract: OBJECTIVE
  We investigated whether patients with chronic obstructive pulmonary disease (COPD) who were enrolled in disease-management programmes (DMPs) felt that they received a better quality of care than non-enrolled COPD patients.
  
  
  METHODS
  Our cross-sectional study was performed among patients (n=665) enrolled in four DMPs in the Netherlands. We also evaluated COPD patients (n=227) not enrolled in such programmes. Patients' assessment of chronic-illness care (PACIC) was measured with a 20-item questionnaire. The instrument had five pre-defined domains: patient activation (three items), delivery-system/practice design (three items), goal setting/tailoring (five items), problem solving/contextual (four items), and follow-up/coordination (five items).
  
  
  RESULTS
  THE MEAN OVERALL PACIC SCORE (SCALE: 1-5) of enrolled DMP patients was 2.94, and that of non-enrolled DMP patients was 2.73 (p≤0.01). Differences in the same direction were found in the subscales of patient activation (p≤0.01), delivery-system/practice design (p≤0.001), and problem solving/contextual (p≤0.001).
  
  
  CONCLUSIONS
  Our results suggest that even in the early stages of implementation, DMPs for COPD may significantly improve care.
authors.affiliation: Institute of Health Policy and Management (iBMG), Erasmus University, Rotterdam, The Netherlands.
authors.forename: Jane Murray
authors.initials: JM
authors.lastname: Cramm
authors.forename: Maureen Pmh
authors.initials: MP
authors.lastname: Rutten-Van Mölken
authors.forename: Anna Petra
authors.initials: AP
authors.lastname: Nieboer
keywords: COPD; chronic care; chronic care model; disease management; integrated care