title: [Assessment of a chronic care program in Gerona (CRONIGICAT)].
abstract: OBJECTIVE
  To determine the utility and viability of a chronic care program.
  
  
  METHODS
  Cross-sectional descriptive study with qualitative and quantitative evaluation.
  
  
  METHODS
  26 primary care teams (PCT) from the Catalan health service of Gerona.
  
  
  METHODS
  20 projects within the program. Start 2011.
  
  
  METHODS
  The degree of development of the program, consensus indicators for chronic care, and the Instrument for the Assessment of Chronic Care Models (Instrumento de Evaluación de Modelos de Atención ante la Cronicidad [IEMAC]).
  
  
  RESULTS
  Evaluation of the degree of development: 75% of projects were partially or fully implemented, with a high degree of development in 71% of the PCT. An increasing tendency was found in the consensus indicators for process (patients contacted 48 hours after hospital discharge, population attended in chronic care programs and with the highest risk stratification). There was a slight decrease in the consensus indicators for effectiveness (readmissions, mean length of hospital stay, avoidable hospital admissions, pharmaceutical expenditure, patients attended in the emergency department, and mortality). The dimensions receiving the highest scores on the IEMAC were those evaluating information systems and clinical decision support, while those receiving the lowest scores were community health and self-care.
  
  
  CONCLUSIONS
  When assessing the utility of CRONIGICAT, we believe that progress has been made mainly in its implantation, which has acted as a catalyst for a self-directed shift to a better chronic care model and has identified areas for improvement. We believe that the CRONIGICAT is viable and sustainable, since its actions and projects are integrated within routine clinical practice.
authors.affiliation: Dirección de Atención Primaria, Región Sanitaria de Girona, Institut Català de la Salut, Girona, España. Electronic address: mquesada.girona.ics@gencat.cat.
authors.forename: Miquel
authors.initials: M
authors.lastname: Quesada Sabaté
authors.affiliation: Dirección de Atención Primaria, Región Sanitaria de Girona, Institut Català de la Salut, Girona, España.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Canet Ponsa
authors.affiliation: Dirección de Atención Primaria, Región Sanitaria de Girona, Institut Català de la Salut, Girona, España.
authors.forename: Esteve
authors.initials: E
authors.lastname: Avellana Revuelta
authors.affiliation: Dirección de Atención Primaria, Región Sanitaria de Girona, Institut Català de la Salut, Girona, España.
authors.forename: Sara
authors.initials: S
authors.lastname: Rodriguez Requejo
authors.affiliation: Dirección de Atención Primaria, Región Sanitaria de Girona, Institut Català de la Salut, Girona, España.
authors.forename: Francesc
authors.initials: F
authors.lastname: German Rebull
authors.affiliation: Dirección de Atención Primaria, Región Sanitaria de Girona, Institut Català de la Salut, Girona, España.
authors.forename: Elisabet
authors.initials: E
authors.lastname: Balló Peña
mesh_terms: D002908:Chronic Disease / Q000628:therapy*; D003430:Cross-Sectional Studies; D006801:Humans; D015397:Program Evaluation; D013030:Spain
keywords: Chroniccare; Cronicidad; Evaluación; Evaluation; Health programs; Programas de salud