Patient Assessment Of Chronic Illness Care Of Community Health Center In Three Shandong Urban Cities

Background:Predicting based on the prevalence of chronic diseases in China according to2008survey results20%, doctor-confirmed diagnosis of chronic disease cases will reach260million nationwide. In the next decade, if there was no effective intervention, death of chronic diseases in China will grow by19%, the number of deaths in diabetic patients may reach50%growth rate. According to the World Health Organization’s prediction, by2015, the direct medical costs due to chronic disease in our country will be up to U.S.$500billion. Chronic diseases not only affect people’s health in China, the enormous pressure on the health services system, but also will be a serious drain on the results of the socio-economic development and resources. The new health care reform promotes the equalization of public health services through establishing health records and chronic disease management by community health agencies. Community health center taking the responsibility of chronic disease management tasks, has become the general consensus.Therefore, to investigate chronic disease management status quo and to explore effective means to enhance its service capabilities for chronic disease management has an important significance.Objective:To verify the PACIC (Patient Assessment of Chronic Illness Care) scale and to explore new evaluation methods for community chronic disease management. Based on the outcome of PACIC, to investigate the influencing factors affecting PACIC, and to come up with corresponding policy recommendations.Methods:We selected from three Shandong urban cities3-4community health centers and8-12community health station randomly for investigation. Data analysis methods include:1) descriptive analysis2) Chi-square test, analysis of variance single factor analysis3) Reliability and Validity analysis of PACIC scale4) multi-factor analysis.Results:According to the result of PACIC scale, the respondents attribute grouping average scores of different dimensions range from2.0to3.4out of5, and also at a low level compared with other countries. The result of PACIC scale analysis shows that the patients who are female, small age, medical insurance for public health services, show a higher score. The different organizers of the community health service organizations show different scores, specially, corporate-sponsored community health services have the lowest scores, the difference was statistically significant. The community physician’s gender, education, work experience has statistically significant effect on scores of the PACIC Scale. Among them, the men, with higher education, and longer work experience, corresponds to PACIC higher scores.Suggestions and Discussion:1. Allocate special funds to chronic disease management, use innovative incentive mechanisms to encourage high-quality chronic disease management practice.2. Strengthen the doctors’continuous education. Provide patient-centered care, and enhance patients’self-management support.3. Expand the practice team, use IT and non-medical members to improve chronic disease management. In addition to the rational use of information systems, chronic disease management system should also strive to get active support from family members and other non-medical members of the community. 4. Strengthen the collaboration between different medical institutions to share research results, reduce the cost of the implementation of chronic disease management.