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

Figures & data

Figure 1. Flowchart study sample.

Table I. Characteristics of the generic sample of patients with chronic somatic illness (n = 1377) and the extra sample of patients diagnosed with COPD (n = 225).

	Generic sample		Additional sample of COPD patients
	n	%	n	%
Patient characteristics:
Gender
Male	632	46	131	58
Female	745	54	94	42
Age:
15–39 years	69	5	0	0
40–64 years	639	46	91	40
65–74 years	383	28	79	35
≥ 75 years	286	21	55	25
Educational level:
Low	489	36	119	53
Intermediate	549	41	71	32
High Health literacy:^1	309	23	33	15
Inadequate	102	8	20	9
Adequate	1229	92	195	91
Type of chronic disease diagnosed:^2
Asthma	159	12	20	9
COPD	146	11	225	100
Other chronic respiratory disease	70	5	5	2
Cardiovascular disease/high risk	403	29	51	23
Arthritis	219	16	11	5
Other chronic musculoskeletal disorder	136	10	7	3
Cancer	132	10	5	2
Diabetes mellitus	332	24	21	9
Thyroid dysfunction	115	8	7	3
Migraine	63	5	1	0
Neurological disease	78	6	3	1
Chronic digestive disorder	91	7	8	4
Chronic skin disease	113	8	4	2
Other chronic disease	225	16	15	7
Number of chronic diseases diagnosed:
One	714	52	113	50
Two	397	29	72	32
Three or more	266	19	40	18
Self-rated general health:
Excellent	29	2	2	1
Very good	136	10	11	5
Good	735	54	111	49
Fair	424	31	85	38
Poor	45	3	16	7

Notes: ¹Cronbach's alpha was 0.72, indicating good internal consistency. ²Since a proportion of the patients had been diagnosed with more than one chronic disease, these percentages sum up to more than 100.

Table II. Multilevel logistic regression models to estimate ICP use among chronically ill patients within general practice (n = 1371).

	Model 0		Model 1
Fixed part			OR (95% CI)	SE
Age, years (ref. 15–64 years):
65–74 years			0.84 (0.54–1.31)	0.19
≥ 75 years			0.86 (0.52–1.41)	0.22
Educational level (ref. = low):
Intermediate			1.20 (0.80–1.81)	0.25
High			0.50 (0.27–0.94)*	0.16
Health literacy: adequate (ref. = inadequate)			0.66 (0.37–1.17)	0.19
Type of chronic disease diagnosed (ref. = absence of specific disease):
Asthma			0.95 (0.47–1.89)	0.33
COPD			1.74 (1.01–2.98)*	0.48
Other chronic respiratory disease			1.39 (0.54–3.54)	0.66
Cardiovascular disease / high risk			1.05 (0.61–1.80)	0.29
Arthritis			0.97 (0.52–1.82)	0.31
Other chronic musculoskeletal disorder			1.42 (0.72–2.80)	0.49
Cancer			1.01 (0.47–2.18)	0.40
Diabetes mellitus			1.78 (1.06–2.98)*	0.47
Thyroid dysfunction			1.12 (0.54–2.35)	0.42
Migraine			0.43 (0.10–1.86)	0.32
Neurological disease			1.76 (0.81–3.84)	0.70
Chronic digestive disorder			1.18 (0.50–2.78)	0.52
Chronic skin disease			0.79 (0.31–1.98)	0.37
Other chronic disease			1.81 (1.05–3.14)*	0.51
Multimorbidity present (ref. = absent)			0.88 (0.47–1.64)	0.28
Self-rated general health (ref. = excellent–very good)
Good			4.16 (1.28–13.58)*	2.51
Fair–poor			5.51 (1.67–18.15)**	3.35

Random part	Estimate	SE	Estimate	SE
Variance between GP practices	0.06	0.10	0.00	0.00

Notes: Significance levels: *p < 0.05; ** p < 0.01. OR = odds ratio; CI = confidence interval; SE = standard error.

Table III. Mean PACIC scores of patients with and without an ICP and results of Student's t-tests for independent samples.

	α	Patients with ICP		Patients without ICP		t	df	p
		M (SD)	n	M (SD)	n
PACIC total score	0.93	2.67 (1.00)	116	1.94 (0.74)	741	–7.636	135.75	< 0.001
Patient activation	0.83	3.33 (1.39)	120	2.76 (1.38)	764	–4.210	882	< 0.001
Delivery system design/decision support	0.68	3.19 (1.17)	120	2.60 (1.06)	757	–5.622	875	< 0.001
Goal setting	0.81	2.53 (1.15)	116	1.81 (0.91)	733	–6.474	138.968	< 0.001
Problem-solving/contextual counselling	0.93	2.85 (1.33)	113	1.75 (1.05)	713	–8.331	135.206	< 0.001
Follow-up/coordination	0.73	1.78 (0.91)	110	1.36 (0.57)	735	–4.626	122.437	< 0.001

Notes: M = mean; SD = standard deviation; t = t-value; df = degrees of freedom; p = significance level.