Assessment of the quality of primary care for the elderly according to the Chronic Care Model.
Líliam Barbosa Silva, Sônia Maria Soares, Patrícia Aparecida Barbosa Silva and 3 others
PMID 29538582WHAT IT FOUND
Scores did not track blood sugar, cholesterol, kidney, weight or blood-pressure outcomes except quality of life and satisfaction, but older adults with diabetes or hypertension rated primary chronic care poorly, averaging 1.55 on a 1-to-5 scale.
Key findings
01The median overall PACIC score was 1.55, on a scale from 1 to 5, indicating low perceived quality of care.
02More than half answered almost never to 16 of the 20 evaluated PACIC items.
03No significant difference was found between overall PACIC scores and individual care outcomes, but a significant difference was found for older people reporting good quality of life and satisfaction with health, with medians of 1.83 and 1.40.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional, so it cannot show that higher PACIC scores caused better care outcomes. It included only older people from one health district in Belo Horizonte, and the paper notes no national or international studies with only elderly public health service users for comparison. Quality of care was based on patients recall and responses to the PACIC questionnaire, and the paper says selective response bias cannot be excluded. People with severe cognitive impairment and no responsible person to assist with responses were excluded, and 13 of 118 eligible patients did not respond to the PACIC questionnaire.
The easy way to misread this
Do not conclude that higher PACIC scores improve blood sugar, cholesterol, kidney function, weight, or blood pressure. The study found no significant difference between overall PACIC scores and individual care outcomes, except for perceived quality of life and satisfaction.