Patient assessment of chronic illness care (PACIC) and improved patient-centered outcomes for chronic conditions

BACKGROUND: The Patient Assessment of Chronic illness Care (PACIC) has potential for use as a patient-centered measure of the implementation of the Chronic Care Model (CCM), but there is little research on the relationship between the PACIC and important behavioral and quality measures for patients with chronic conditions. OBJECTIVE: To examine the relationship between PACIC scores and self-management behaviors, patient rating of their health care, and self-reported quality of life. DESIGN: Cross-sectional survey with a 61% response rate. PARTICIPANTS: Included in the survey were 4,108 adults with diabetes, chronic pain, heart failure, asthma, or coronary artery disease in the Kaiser Permanente Medical Care program across 7 regions nationally. MEASUREMENTS: The PACIC was the main independent variable. Dependent variables included use of self-management resources, self-management behaviors such as regular exercise, self-reported adherence to medications, patient rating of their health care, and quality of life. RESULTS: PACIC scores were significantly, positively associated with all measures (odds ratio (ORs) ranging from 1.20 to 2.36) with the exception of self-reported medication adherence. CONCLUSIONS: Use of the PACIC, a practical, patient-level assessment of CCM implementation, could be an important tool for health systems and other stakeholders looking to improve the quality of chronic disease care.