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.

Keywords

• chronic care
• integrated care
• disease management
• COPD
• chronic care model