Improving primary care for patients with chronic illness - The chronic care model, part 2
Improving primary care for patients with chronic illness - The chronic care model, part 2
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DOI：
10.1001/jama.288.15.1909
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发表时间：
2002-10-16
影响因子：
120.7
通讯作者：
Grumbach, K
中科院分区：
文献类型：
--
作者：
Bodenheimer, T;Wagner, EH;Grumbach, K
本文回顾了研究证据，表明慢性病护理模式在多大程度上可以改善慢性病的管理（以糖尿病为例）和降低医疗费用。39项研究中的32项发现，基于慢性护理模式组件的干预措施改善了糖尿病患者的至少1个过程或结果指标。关于慢性病护理模式干预措施是否可以降低成本，27项研究中有18项涉及3种慢性病（充血性心力衰竭、哮喘和糖尿病），表明医疗保健成本降低或医疗保健服务使用率降低。尽管慢性病护理模式有可能改善护理并降低成本，但仍有一些障碍阻碍其广泛采用。
This article reviews research evidence showing to what extent the chronic care model can improve the management of chronic conditions (using diabetes as an example) and reduce health care costs. Thirty-two of 39 studies found that interventions based on chronic care model components improved at least 1 process or outcome measure for diabetic patients. Regarding whether chronic care model interventions can reduce costs, 18 of 27 studies concerned with 3 examples of chronic conditions (congestive heart failure, asthma, and diabetes) demonstrated reduced health care costs or lower use of health care services. Even though the chronic care model has the potential to improve care and reduce costs, several obstacles hinder its widespread adoption.