--- title: "Chronic care model and pt health status & QoL | Sutter Health" description: "A practice's implementation of the chronic care model was significantly related to patient health status and health-related QOL." url: "https://www.sutterhealth.org/research/publications/chronic-care-model-pt-health-status-qol-1055312441" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Chronic care model and pt health status & QoL # The chronic care model and relationships to patient health status and health-related quality of life. Hung DY, Glasgow RE, Dickinson LM, Froshaug DB, Fernald DH, Balasubramanian BA, & Green LA. _Am J Prev Med. 35(5 Suppl):S398-406. doi: 10.1016/j.amepre.2008.08.009._ 2008-11-01 ## Abstract BACKGROUND: The chronic care model (CCM) is a system-level framework used to guide quality improvement efforts in health care. However, little is known about its relationship to patient-level health measures. This study describes the implementation of the CCM as adapted for prevention and health behavior counseling in primary care practices, and examines relationships between the CCM and patient health measures, including general health status and health-related quality of life (HRQOL). METHODS: Baseline data from Round 2 of the Prescription for Health initiative (2005-2007) were used to assess CCM implementation in 57 practices located nationwide. Relationships between the CCM and three separate measures of health among 4735 patients were analyzed in 2007. A hierarchical generalized linear modeling approach to ordinal regression was used to estimate categories of general health status, unhealthy days, and activity-limiting days, adjusting for patient covariates and clustering effects. RESULTS: Outcome variances were significantly accounted for by differences in practice characteristics (p<0.001). Practices that used individual or group planned visits were more likely to see patients in lower health categories across all measures (OR=0.74-0.81, p<0.05). Practices that used patient registries, health promotion champions, evidence-based guidelines, publicly reported performance measures, and support for behavior change were associated with higher patient health levels (OR=1.28-1.98, p<0.05). CONCLUSIONS: A practice's implementation of the CCM was significantly related to patient health status and HRQOL. Adapting the CCM for prevention may serve to reorient care delivery toward more proactive behavior change and improvements in patient health outcomes. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/18929987) ## Research topics - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) - [Prevention and Health Maintenance](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Prevention+and+Health+Maintenance%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Frontline perspectives on physician burnout and strategies to improve well-being: interviews with physicians and health system leaders.](https://www.sutterhealth.org/research/publications/strategies-to-improve-physician-burnout-1055312678) Dillon EC, Tai-Seale M, Meehan A, Martin V, Nordgren R, Lee T, Nauenberg T, Frosch DL. J Gen Intern Med. doi: 10.1007/s11606-019-05381-0. \[Epub ahead of print\] 2019 Oct 28 - Publication ### [Developing a health care intermediary-delivered intervention to promote an online health information resource: results from formative research](https://www.sutterhealth.org/research/publications/intervention-promote-online-health-info-resource-1055312295) Li J, Quinn J, Rico CL, Noguera AC, Silbajoris C, Brown JD, McDuffee D. J Consum Health Internet. 2010;14(4):369-381. 2010 Nov 25 - Publication ### [Prioritization of evidence-based preventive health services during periodic health examinations.](https://www.sutterhealth.org/research/publications/priority-of-preventive-health-services-in-visits-1055312580) Shires DA, Stange KC, Divine G, Ratliff S, Vashi R, Tai-Seale M, Lafata JE. Am J Prev Med. 42(2):164-73. doi: 10.1016/j.amepre.2011.10.008. 2012 Feb 01 - Publication ### [Practice-level approaches for behavioral counseling and patient health behaviors.](https://www.sutterhealth.org/research/publications/practice-level-approach-beh-counsel-pt-health-behs-1055312530) Balasubramanian BA, Cohen DJ, Clark EC, Isaacson NF, Hung DY, Dickinson LM, Fernald DH, Green LA, Crabtree BF. Am J Prev Med. 35(5 suppl):S407-13. doi: 10.1016/j.amepre.2008.08.004. 2008 Nov 01 - Publication ### [Why do we observe a limited impact of primary care access measures on clinical quality indicators?](https://www.sutterhealth.org/research/publications/impact-of-primary-care-access-on-clinical-quality-1055312662) Chung S, Panattoni L, Hung D, Johns N, Trujillo L, Tai-Seale M. J Ambul Care Manage. 37(2):155-63. doi: 10.1097/JAC.0000000000000026. 2014 Apr 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/chronic-care-model-pt-health-status-qol-1055312441#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Chronic care model and pt health status & QoL"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/chronic-care-model-pt-health-status-qol-1055312441#medicalscholarlyarticle","name":"The chronic care model and relationships to patient health status and health-related quality of life.","headline":"Chronic care model and pt health status & QoL","abstract":"BACKGROUND: The chronic care model (CCM) is a system-level framework used to guide quality improvement efforts in health care. However, little is known about its relationship to patient-level health measures. This study describes the implementation of the CCM as adapted for prevention and health behavior counseling in primary care practices, and examines relationships between the CCM and patient health measures, including general health status and health-related quality of life (HRQOL). METHODS: Baseline data from Round 2 of the Prescription for Health initiative (2005-2007) were used to assess CCM implementation in 57 practices located nationwide. Relationships between the CCM and three separate measures of health among 4735 patients were analyzed in 2007. A hierarchical generalized linear modeling approach to ordinal regression was used to estimate categories of general health status, unhealthy days, and activity-limiting days, adjusting for patient covariates and clustering effects. RESULTS: Outcome variances were significantly accounted for by differences in practice characteristics (p\u003c0.001). Practices that used individual or group planned visits were more likely to see patients in lower health categories across all measures (OR=0.74-0.81, p\u003c0.05). Practices that used patient registries, health promotion champions, evidence-based guidelines, publicly reported performance measures, and support for behavior change were associated with higher patient health levels (OR=1.28-1.98, p\u003c0.05). CONCLUSIONS: A practice's implementation of the CCM was significantly related to patient health status and HRQOL. Adapting the CCM for prevention may serve to reorient care delivery toward more proactive behavior change and improvements in patient health outcomes.","description":"A practice's implementation of the chronic care model was significantly related to patient health status and health-related QOL.","keywords":["Health Services","Prevention and Health Maintenance"],"datePublished":"2008-11-01","url":"https://www.sutterhealth.org/research/publications/chronic-care-model-pt-health-status-qol-1055312441","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"PMID","value":"18929987"},{"@type":"PropertyValue","propertyID":"DOI","value":"10.1016/j.amepre.2008.08.009"}],"sameAs":["https://pubmed.ncbi.nlm.nih.gov/18929987/","https://doi.org/10.1016/j.amepre.2008.08.009"],"isPartOf":{"@type":"Periodical","name":"Am J Prev Med"},"author":[{"@type":"Person","name":"Hung DY"},{"@type":"Person","name":"Glasgow RE"},{"@type":"Person","name":"Dickinson LM"},{"@type":"Person","name":"Froshaug DB"},{"@type":"Person","name":"Fernald DH"},{"@type":"Person","name":"Balasubramanian BA"},{"@type":"Person","name":"Green LA"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Health Services","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Services%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Prevention and Health Maintenance","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Prevention+and+Health+Maintenance%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/chronic-care-model-pt-health-status-qol-1055312441","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/chronic-care-model-pt-health-status-qol-1055312441#breadcrumblist"}}} ```