Better outpatient care processes can improve the quality of life for patients with chronic disease

Better outpatient care processes can improve the quality of life for patients with chronic disease

When clinicians use appropriate processes of care, they can improve the quality of life of managed care outpatients suffering from chronic disease, according to a new study. For example, regular foot and eye inspections for patients with diabetes, regular lung exams for patients with asthma, and use of beta-blockers for those who have suffered a heart attack are all important processes of care that can improve patient quality of life.

Researchers found that applying the best quartile of process of care to patients who were not receiving recommended diagnostic, monitoring, and treatment (worst quartile of process of care) was associated with a 4.24 increase in physical functioning scores.

This improvement was comparable to eradicating 3 years of aging and underscores the importance of efforts to improve the process of care, notes Diana M. Tisnado, Ph.D., of the University of California, Los Angeles. Dr. Tisnado and fellow researchers examined patient self-reports and medical records of 963 patients with at least 1 of the following chronic health problems: ischemic heart disease, asthma and/or emphysema, or diabetes. The patients were enrolled in managed care plans from three West Coast States.

The researchers correlated receipt of 120 generic and disease-specific processes of care with patient changes in health-related quality of life scores across 30 months as measured by changes in the SF-12 physical component scores. After adjusting for patients' burden of illness, the researchers found an improvement of 4.24 points in the SF-12 physical component scores from 1996 to 1998 as process of care changed from the worst quartile to the best quartile of care process scores. The study was supported in part by the Agency for Healthcare Research and Quality (HS00046).

See "Does ambulatory process of care predict health-related quality of life outcomes for patients with chronic disease?" by Katherine L. Kahn, M.D., Dr. Tisnado, John L. Adams, Ph.D., and others, in the February 2007 HSR: Health Services Research 42(1), pp. 63-83.

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