Variables affecting quality of care of the outpatients having a chronic condition; [Kronik hastalığı nedeniyle ayaktan izlenen hastaların aldıkları sağlık hizmetlerinin niteliğini etkileyen değişkenler]

Objective: The best known, most effective and widely used model for chronic illness management is “Chronic Care Model”. Patient Assessment of Care for Chronic Conditions (PACIC) (KBDh) is designed according to this model. The objectives of this study are; 1. To test the sensitivity of PACIC to diverse socio-economic and condition specific variables and 2. To define the quality of care (QOC) and the affecting variables on QOC of the patients in the outpatient wards of CBU hospital. Materials and Methods: In this descriptive study, we enrolled patients from Celal Bayar University Hospital, Departments of Internal Medicine (Endocrinology, Nephrology, Rheumatology, Oncology, and Gastroenterology), Neurology, Dermatology, and Pulmonary Medicine outpatient clinics. Patients were under follow-up care for more than 6 months (n=295) and they were asked to fill the survey containing PACIC scale, socio-demographic variables and other morbidity variables. Type 1 error was adopted as 0.05 and the SPSS 15.0 was used for statistical analysis. Results: The mean age was 51.6±15.2; 18.3% of patients aged 65 and over, and 64.7% were female. 28.8% of patients had type 2diabetes, 29.5% had hypertension, 16.7% had COPD, 15.5% had neurological disease (migraine, epilepsy, MS) and 9.5% had chronic allergic diseases. The mean duration of disease was 9.3±7.9 years, and there was at least one comorbidity in 48.8% of the patients. The overall PACIC scale score was 2.81±0.86. Lower education and income status; the lack of social security and migration to the region negatively affected the quality of follow-up (p<0.05). Patients with hypertension were more negatively affected than the other chronic illness patients in terms of patient activation and goal setting/tailoring dimension scores (p<0.05). Having continuous monitoring by a particular physician and having this physician as primary care physician increased the quality of monitoring (p<0.05). Also, for all chronic diseases and for all dimensions, improvement in quantity of monitoring improved quality of monitoring. Conclusion: Given the PACIC (KBDh) the total score and dimension scores and considering that patients were followed at a university hospital, the scores in this study show that the quality of monitoring is not sufficient level of. Monitoring of the patients in primary care conditions instead of at the second level improves the quality of follow-up. © GATA.