title: Better experiences with quality of care predict well-being of patients with chronic obstructive pulmonary disease in the Netherlands.
abstract: OBJECTIVE
  This study was conducted to (1) identify improvements in care quality and well-being of patients with chronic obstructive pulmonary disease in the Netherlands and (2) investigate the longitudinal relationship between these factors.
  
  
  METHODS
  This longitudinal study was conducted among patients diagnosed with chronic obstructive pulmonary disease enrolled in the Kennemer Lucht care programme in the Netherlands. Biomarker data (lung capacity) were collected at patients' health care practices in 2012. Complete case analysis was conducted, and the multiple imputation technique allowed us to report pooled results from imputed datasets.
  
  
  RESULTS
  Surveys were filled out by 548/1303 (42%) patients at T0 (2012) and 569/996 (57%) remaining participants at T1. Quality of care improved significantly (p < 0.05). Analyses adjusted for well-being at T0, age, educational level, marital status, gender, lung function and health behaviours showed that patients' assessments of the quality of chronic care delivery at T0 (p < 0.01) and changes therein (p < 0.001) predicted patients' well-being at T1.
  
  
  CONCLUSIONS
  These results clearly show that the quality of care and changes therein are important for the well-being of patients with chronic obstructive pulmonary disease in the primary care setting.
  
  
  CONCLUSIONS
  To improve quality of care for chronically ill patients, multicomponent interventions may be needed.
authors.affiliation: Department of Health Policy and Management (iBMG), Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors.forename: Jane Murray
authors.initials: JM
authors.lastname: Cramm
authors.affiliation: Department of Methodology and Statistics, Utrecht University, Utrecht, The Netherlands.
authors.forename: Shahab
authors.initials: S
authors.lastname: Jolani
authors.affiliation: Department of Methodology and Statistics, Utrecht University, Utrecht, The Netherlands.
authors.forename: Stef
authors.initials: S
authors.lastname: van Buuren
authors.affiliation: Department of Health Policy and Management (iBMG), Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors.forename: Anna Petra
authors.initials: AP
authors.lastname: Nieboer
keywords: chronic obstructive pulmonary disease; disease management; health behaviour; quality of care; well-being