title: High-quality chronic care delivery improves experiences of chronically ill patients receiving care.
abstract: OBJECTIVE
  Investigate whether high-quality chronic care delivery improved the experiences of patients.
  
  
  METHODS
  This study had a longitudinal design.
  
  
  METHODS
  We surveyed professionals and patients in 17 disease management programs targeting patients with cardiovascular diseases, chronic obstructive pulmonary disease, heart failure, stroke, comorbidity and eating disorders.
  
  
  METHODS
  Patients completed questionnaires including the Patient Assessment of Chronic Illness Care (PACIC) [T1 (2010), 2637/4576 (58%); T2 (2011), 2314/4330 (53%)]. Professionals' Assessment of Chronic Illness Care (ACIC) scores [T1, 150/274 (55%); T2, 225/325 (68%)] were used as a context variable for care delivery. We used two-tailed, paired t-tests to investigate improvements in chronic illness care quality and patients' experiences with chronic care delivery. We employed multilevel analyses to investigate the predictive role of chronic care delivery quality in improving patients' experiences with care delivery.
  
  
  RESULTS
  Overall, care quality and patients' experiences with chronic illness care delivery significantly improved. PACIC scores improved significantly from 2.89 at T1 to 2.96 at T2 and ACIC-S scores improved significantly from 6.83 at T1 to 7.18 at T2. After adjusting for patients' experiences with care delivery at T1, age, educational level, marital status, gender and mental and physical quality of life, analyses showed that the quality of chronic care delivery at T1 (P < 0.001) and changes in care delivery quality (P < 0.001) predicted patients' experiences with chronic care delivery at T2.
  
  
  CONCLUSIONS
  This research showed that care quality and changes therein predict more positive experiences of patients with various chronic conditions over time.
authors.affiliation: Erasmus University (iBMG), Burgemeester Oudlaan 50, 3062 PA Rotterdam, The Netherlands. cramm@bmg.eur.nl.
authors.forename: Jane Murray
authors.initials: JM
authors.lastname: Cramm
authors.forename: Anna Petra
authors.initials: AP
authors.lastname: Nieboer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000628:therapy; D002908:Chronic Disease / Q000628:therapy*; D001068:Feeding and Eating Disorders / Q000628:therapy; D005260:Female; D006333:Heart Failure / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D020521:Stroke / Q000628:therapy; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: chronic care; disease management; integrated care; quality