Stephanie Stock (
James M. Pitcavage is a project manager at the Center for Health Research, Geisinger Health System, in Danville, Pennsylvania, and a PhD candidate in the Department of Health Policy and Administration at the Pennsylvania State University, in University Park.
Health Aff (Millwood). 2014 Sep;33(9):1540-8. doi: 10.1377/hlthaff.2014.0428.
Improving the quality of care for chronic diseases is an important issue for most health care systems in industrialized nations. One widely adopted approach is the Chronic Care Model (CCM), which was first developed in the late 1990s. In this article we present the results from two large surveys in the United States and Germany that report patients' experiences in different models of patient-centered diabetes care, compared to the experiences of patients who received routine diabetes care in the same systems. The study populations were enrolled in either Geisinger Health System in Pennsylvania or Barmer, a German sickness fund that provides medical insurance nationwide. Our findings suggest that patients with type 2 diabetes who were enrolled in the care models that exhibited key features of the CCM were more likely to receive care that was patient-centered, high quality, and collaborative, compared to patients who received routine care. This study demonstrates that quality improvement can be realized through the application of the Chronic Care Model, regardless of the setting or distinct characteristics of the program.
改善慢性病护理质量是大多数工业化国家医疗保健系统的重要问题。一种广泛采用的方法是慢性病护理模式（CCM），它于 20 世纪 90 年代末首次提出。本文介绍了美国和德国的两项大型调查结果，这些调查比较了不同以患者为中心的糖尿病护理模式下患者的体验，以及同一系统中接受常规糖尿病护理的患者的体验。研究人群分别参加了宾夕法尼亚州的 Geisinger 卫生系统或 Barmer，后者是一家提供全国医疗保险的德国疾病基金。我们的研究结果表明，与接受常规护理的患者相比，参加表现出 CCM 关键特征的护理模式的 2 型糖尿病患者更有可能接受以患者为中心、高质量和协作的护理。这项研究表明，无论设置或计划的独特特征如何，通过应用慢性病护理模式都可以实现质量改进。
