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New Zealand health professional and patient perceptions of chronic illness care

Fiona Doolan-Noble, Robin Gauld, Debra L Waters, Sophia Leon de la Barra


Background: In 2004 the New Zealand Ministry of Health announced additional funding, called Care Plus, for primary care to enhance provision of chronic illness care. There has, however, been no national evaluation of the impact of this additional funding.

Objective: The main purpose of this study was to assess patient and primary health care provider (PHCPs) perceptions of chronic illness care in the Southern region of New Zealand.

Design and Setting: Cross-sectional survey of patients with multiple chronic conditions in conjunction with a survey of all PHCPs in the Southern Region of New Zealand.

Method: The Modified Patient Assessment of Chronic Illness Care (M-PACIC) survey was mailed to a random sample of 500 patients enrolled in Care Plus and all PHCPs in the region. M-PACIC assesses care across six domains: patient activation; delivery system; goal setting; problem solving; follow up and care coordination; and cultural sensitivity.

Results: Thirty-one percent (n=198) of PHCPs responded compared to fifty-two percent (n= 259) of patients. At least one response was received from 77% of general practices in the region. The difference in perceptions of care between patients and PHCPs was statistically significant (p=<0.001) across five of the six domains, with the delivery system domain also reaching statistical significance (p=0.018).

Conclusion: Overall, patients reported lower chronic care competency scores than health professionals. This suggests that additional funding provided to primary care via the Care Plus programme has not improved the health care experiences of patients living with chronic illness in the region.

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