Opposite trends in hospitalization and mortality after implementation of a chronic care model-based regional program for the management of patients with heart failure in primary care

BMC Health Services Research
Piercarlo BalloAlfredo Zuppiroli

Abstract

The chronic care model (CCM) is an established framework for the management of patients with chronic illness at the individual and population level. Its application has been previously shown to improve clinical outcome in several conditions, but the prognostic impact of CCM-based programs for the management of patients with chronic heart failure (HF) in primary care is still to be elucidated. We assessed the prognostic impact of a primary-care, CCM-based project applied in Tuscany, Italy, in 1761 patients with chronic HF enrolled in a retrospective matched cohort study. The project was based on predefined working teams including general practitioners and nurses, proactively scheduled regular follow-up visitations for each patient, counseling for therapy adherence and lifestyle modifications, appropriate diagnostic and therapeutic pathways according to international guidelines, and a key supporting role of the nurses, who were responsible for the practical coordination of the follow-up. A matched group of 3522 HF subjects assisted by general practitioners not involved in the project was considered as control group. The endpoints of this study were HF hospitalization and all-cause mortality. Over a 4-year follow-up period, HF hos...Continue Reading

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Citations

Aug 29, 2019·Health Services Insights·Paolo FrancesconiAlfredo Zuppiroli
Oct 18, 2019·Health Services Management Research : an Official Journal of the Association of University Programs in Health Administration·Sara Barsanti, Francesca Guarneri
Jun 22, 2021·Health Services Management Research : an Official Journal of the Association of University Programs in Health Administration·David YouensRachael Moorin

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