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Cross-sectional survey of older patients’ views regarding multidisciplinary care for chronic conditions in general practice

Journal Article


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Abstract


  • The ageing population and increasing prevalence of chronic illness have contributed to the need for significant primary care reform, including increased use of multidisciplinary care and task substitution. This cross-sectional study explores conditions under which older patients would accept having health professionals other than their general practitioner (GP) involved in their care for chronic disease management (CDM). Ten practices were randomly sampled from a contiguous major city and inner regional area. Questionnaires were distributed to consecutive patients aged 60 years and over in each practice. Agency theory was used to inform analyses. Statistical analysis was undertaken using Wald’s test, growth modelling and linear regression, controlling for the clustered design. The response rate was 53% (n = 272). Most respondents (79%) had at least one chronic health condition. Respondents were more comfortable with GP than with practice nurse management in the CDM scenario (Wald’s test = 105.49, P < 0.001). Comfort with practice nurse CDM was positively associated with increased contact with their GP at the time of the visit (β = 0.41, P < 0.001), negatively associated with the number of the respondent’s chronic conditions (β = –0.13, P = 0.030) and not associated with the frequency of other health professional visits. Agency theory suggests that patients employ continuity of care to optimise factors important in CDM: information symmetry and goal alignment. Our findings are consistent with the theory and lend support to ensuring that interpersonal continuity of care is not lost in health care reform. Further research exploring patients’ acceptance of differing systems of care is required.

Publication Date


  • 2014

Citation


  • Bonney, A., Magee, C. & Pearson, R. (2014). Cross-sectional survey of older patients’ views regarding multidisciplinary care for chronic conditions in general practice. Australian Journal of Primary Health: the issues influencing community health services and primary health care, 20 (1), 27-33.

Scopus Eid


  • 2-s2.0-84894157419

Ro Full-text Url


  • http://ro.uow.edu.au/cgi/viewcontent.cgi?article=2209&context=smhpapers

Ro Metadata Url


  • http://ro.uow.edu.au/smhpapers/1191

Has Global Citation Frequency


Number Of Pages


  • 6

Start Page


  • 27

End Page


  • 33

Volume


  • 20

Issue


  • 1

Place Of Publication


  • Australia

Abstract


  • The ageing population and increasing prevalence of chronic illness have contributed to the need for significant primary care reform, including increased use of multidisciplinary care and task substitution. This cross-sectional study explores conditions under which older patients would accept having health professionals other than their general practitioner (GP) involved in their care for chronic disease management (CDM). Ten practices were randomly sampled from a contiguous major city and inner regional area. Questionnaires were distributed to consecutive patients aged 60 years and over in each practice. Agency theory was used to inform analyses. Statistical analysis was undertaken using Wald’s test, growth modelling and linear regression, controlling for the clustered design. The response rate was 53% (n = 272). Most respondents (79%) had at least one chronic health condition. Respondents were more comfortable with GP than with practice nurse management in the CDM scenario (Wald’s test = 105.49, P < 0.001). Comfort with practice nurse CDM was positively associated with increased contact with their GP at the time of the visit (β = 0.41, P < 0.001), negatively associated with the number of the respondent’s chronic conditions (β = –0.13, P = 0.030) and not associated with the frequency of other health professional visits. Agency theory suggests that patients employ continuity of care to optimise factors important in CDM: information symmetry and goal alignment. Our findings are consistent with the theory and lend support to ensuring that interpersonal continuity of care is not lost in health care reform. Further research exploring patients’ acceptance of differing systems of care is required.

Publication Date


  • 2014

Citation


  • Bonney, A., Magee, C. & Pearson, R. (2014). Cross-sectional survey of older patients’ views regarding multidisciplinary care for chronic conditions in general practice. Australian Journal of Primary Health: the issues influencing community health services and primary health care, 20 (1), 27-33.

Scopus Eid


  • 2-s2.0-84894157419

Ro Full-text Url


  • http://ro.uow.edu.au/cgi/viewcontent.cgi?article=2209&context=smhpapers

Ro Metadata Url


  • http://ro.uow.edu.au/smhpapers/1191

Has Global Citation Frequency


Number Of Pages


  • 6

Start Page


  • 27

End Page


  • 33

Volume


  • 20

Issue


  • 1

Place Of Publication


  • Australia