Individual care plans for chronically ill patients within primary care in the Netherlands: Dissemination and associations with patient characteristics and patient-perceived quality of care

Abstract

Objective. To examine the use of individual care plans (ICPs) within primary chronic illness care in the Netherlands, and to explore the relationships between ICP use, patient characteristics, and patient-perceived quality of care. Design. Cross-sectional study using survey data from a panel of chronically ill patients and medical registration data provided by their general practices. Setting and subjects. A sample of 1377 patients with somatic chronic disease(s) randomly selected in general practices throughout the Netherlands, supplemented with a sample of 225 COPD patients, also recruited from general practices. Main outcome measures. (i) Percentage of ICP use based on self-report by chronically ill patients, and (ii) patient-perceived quality of care as assessed using the Patient Assessment of Chronic Illness Care (PACIC). Results. ICP use among the total generic sample was low (9%), but slightly higher (13%) among patients diagnosed with diabetes or COPD, diseases for which disease management programmes have been set up in the Netherlands. Patients with a low educational level and patients with poor(er) self-rated health were more likely to have an ICP. Compared with patients without an ICP, patients with an ICP more often reported that the care they received was patient-centred, proactive, planned, and included collaborative goal setting, problem-solving, and follow-up support. Conclusion and implications. Findings reveal a discrepancy between practice and policy aspirations regarding ICP use in primary chronic illness care. More research is needed to gain insight into the effectiveness of ICPs to improve the quality of chronic illness care in various patient populations.

Key Words::

• Chronic disease
• chronic obstructive pulmonary disease
• diabetes mellitus
• disease management
• general practice
• patient care planning
• quality of health care
• the Netherlands

Acknowledgements

The authors wish to thank all participating general practitioners and panel members with chronic diseases. This study formed part of the research programme “National Panel of people with Chronic illness or Disability” (NPCD), which is financed by the Netherlands Ministry of Health, Welfare and Sport and the Netherlands Ministry of Social Affairs and Employment.

Declaration of interest

All authors declare to have no competing interests. The authors alone are responsible for the content and writing of the paper.