Relationships between structure, process and outcome to assess quality of integrated chronic disease management in a rural South African setting: applying a structural equation model.
Identifieur interne : 000910 ( PubMed/Corpus ); précédent : 000909; suivant : 000911Relationships between structure, process and outcome to assess quality of integrated chronic disease management in a rural South African setting: applying a structural equation model.
Auteurs : Soter Ameh ; Francesc Xavier G Mez-Olivé ; Kathleen Kahn ; Stephen M. Tollman ; Kerstin Klipstein-GrobuschSource :
- BMC health services research [ 1472-6963 ] ; 2017.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Ambulatory Care (standards), Chronic Disease (epidemiology), Chronic Disease (therapy), Cross-Sectional Studies, Delivery of Health Care, Integrated (standards), Female, Humans, Longitudinal Studies, Male, Middle Aged, Patient Satisfaction, Primary Health Care (standards), Quality Assurance, Health Care (standards), Quality of Health Care (standards), Rural Health, South Africa (epidemiology), Surveys and Questionnaires, Young Adult.
- MESH :
- epidemiology : Chronic Disease, South Africa.
- standards : Ambulatory Care, Delivery of Health Care, Integrated, Primary Health Care, Quality Assurance, Health Care, Quality of Health Care.
- therapy : Chronic Disease.
- Adolescent, Adult, Aged, Cross-Sectional Studies, Female, Humans, Longitudinal Studies, Male, Middle Aged, Patient Satisfaction, Rural Health, Surveys and Questionnaires, Young Adult.
Abstract
South Africa faces a complex dual burden of chronic communicable and non-communicable diseases (NCDs). In response, the Integrated Chronic Disease Management (ICDM) model was initiated in primary health care (PHC) facilities in 2011 to leverage the HIV/ART programme to scale-up services for NCDs, achieve optimal patient health outcomes and improve the quality of medical care. However, little is known about the quality of care in the ICDM model. The objectives of this study were to: i) assess patients' and operational managers' satisfaction with the dimensions of ICDM services; and ii) evaluate the quality of care in the ICDM model using Avedis Donabedian's theory of relationships between structure (resources), process (clinical activities) and outcome (desired result of healthcare) constructs as a measure of quality of care.
DOI: 10.1186/s12913-017-2177-4
PubMed: 28330486
Links to Exploration step
pubmed:28330486Le document en format XML
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Tollman</name><affiliation><nlm:affiliation>Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.</nlm:affiliation></affiliation></author><author><name sortKey="Klipstein Grobusch, Kerstin" sort="Klipstein Grobusch, Kerstin" uniqKey="Klipstein Grobusch K" first="Kerstin" last="Klipstein-Grobusch">Kerstin Klipstein-Grobusch</name><affiliation><nlm:affiliation>Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2017">2017</date><idno type="RBID">pubmed:28330486</idno><idno type="pmid">28330486</idno><idno type="doi">10.1186/s12913-017-2177-4</idno><idno type="wicri:Area/PubMed/Corpus">000910</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000910</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Relationships between structure, process and outcome to assess quality of integrated chronic disease management in a rural South African setting: applying a structural equation model.</title><author><name sortKey="Ameh, Soter" sort="Ameh, Soter" uniqKey="Ameh S" first="Soter" last="Ameh">Soter Ameh</name><affiliation><nlm:affiliation>Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. sote_ameh@yahoo.com.</nlm:affiliation></affiliation></author><author><name sortKey="G Mez Olive, Francesc Xavier" sort="G Mez Olive, Francesc Xavier" uniqKey="G Mez Olive F" first="Francesc Xavier" last="G Mez-Olivé">Francesc Xavier G Mez-Olivé</name><affiliation><nlm:affiliation>Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.</nlm:affiliation></affiliation></author><author><name sortKey="Kahn, Kathleen" sort="Kahn, Kathleen" uniqKey="Kahn K" first="Kathleen" last="Kahn">Kathleen Kahn</name><affiliation><nlm:affiliation>Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.</nlm:affiliation></affiliation></author><author><name sortKey="Tollman, Stephen M" sort="Tollman, Stephen M" uniqKey="Tollman S" first="Stephen M" last="Tollman">Stephen M. Tollman</name><affiliation><nlm:affiliation>Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.</nlm:affiliation></affiliation></author><author><name sortKey="Klipstein Grobusch, Kerstin" sort="Klipstein Grobusch, Kerstin" uniqKey="Klipstein Grobusch K" first="Kerstin" last="Klipstein-Grobusch">Kerstin Klipstein-Grobusch</name><affiliation><nlm:affiliation>Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.</nlm:affiliation></affiliation></author></analytic><series><title level="j">BMC health services research</title><idno type="eISSN">1472-6963</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Ambulatory Care (standards)</term><term>Chronic Disease (epidemiology)</term><term>Chronic Disease (therapy)</term><term>Cross-Sectional Studies</term><term>Delivery of Health Care, Integrated (standards)</term><term>Female</term><term>Humans</term><term>Longitudinal Studies</term><term>Male</term><term>Middle Aged</term><term>Patient Satisfaction</term><term>Primary Health Care (standards)</term><term>Quality Assurance, Health Care (standards)</term><term>Quality of Health Care (standards)</term><term>Rural Health</term><term>South Africa (epidemiology)</term><term>Surveys and Questionnaires</term><term>Young Adult</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Chronic Disease</term><term>South Africa</term></keywords><keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>Ambulatory Care</term><term>Delivery of Health Care, Integrated</term><term>Primary Health Care</term><term>Quality Assurance, Health Care</term><term>Quality of Health Care</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Chronic Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Cross-Sectional Studies</term><term>Female</term><term>Humans</term><term>Longitudinal Studies</term><term>Male</term><term>Middle Aged</term><term>Patient Satisfaction</term><term>Rural Health</term><term>Surveys and Questionnaires</term><term>Young Adult</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">South Africa faces a complex dual burden of chronic communicable and non-communicable diseases (NCDs). In response, the Integrated Chronic Disease Management (ICDM) model was initiated in primary health care (PHC) facilities in 2011 to leverage the HIV/ART programme to scale-up services for NCDs, achieve optimal patient health outcomes and improve the quality of medical care. However, little is known about the quality of care in the ICDM model. The objectives of this study were to: i) assess patients' and operational managers' satisfaction with the dimensions of ICDM services; and ii) evaluate the quality of care in the ICDM model using Avedis Donabedian's theory of relationships between structure (resources), process (clinical activities) and outcome (desired result of healthcare) constructs as a measure of quality of care.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">28330486</PMID><DateCreated><Year>2017</Year><Month>03</Month><Day>23</Day></DateCreated><DateCompleted><Year>2017</Year><Month>08</Month><Day>28</Day></DateCompleted><DateRevised><Year>2017</Year><Month>08</Month><Day>28</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1472-6963</ISSN><JournalIssue CitedMedium="Internet"><Volume>17</Volume><Issue>1</Issue><PubDate><Year>2017</Year><Month>Mar</Month><Day>23</Day></PubDate></JournalIssue><Title>BMC health services research</Title><ISOAbbreviation>BMC Health Serv Res</ISOAbbreviation></Journal><ArticleTitle>Relationships between structure, process and outcome to assess quality of integrated chronic disease management in a rural South African setting: applying a structural equation model.</ArticleTitle><Pagination><MedlinePgn>229</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s12913-017-2177-4</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">South Africa faces a complex dual burden of chronic communicable and non-communicable diseases (NCDs). In response, the Integrated Chronic Disease Management (ICDM) model was initiated in primary health care (PHC) facilities in 2011 to leverage the HIV/ART programme to scale-up services for NCDs, achieve optimal patient health outcomes and improve the quality of medical care. However, little is known about the quality of care in the ICDM model. The objectives of this study were to: i) assess patients' and operational managers' satisfaction with the dimensions of ICDM services; and ii) evaluate the quality of care in the ICDM model using Avedis Donabedian's theory of relationships between structure (resources), process (clinical activities) and outcome (desired result of healthcare) constructs as a measure of quality of care.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A cross-sectional study was conducted in 2013 in seven PHC facilities in the Bushbuckridge municipality of Mpumalanga Province, north-east South Africa - an area underpinned by a robust Health and Demographic Surveillance System (HDSS). The patient satisfaction questionnaire (PSQ-18), with measures reflecting structure/process/outcome (SPO) constructs, was adapted and administered to 435 chronic disease patients and the operational managers of all seven PHC facilities. The adapted questionnaire contained 17 dimensions of care, including eight dimensions identified as priority areas in the ICDM model - critical drugs, equipment, referral, defaulter tracing, prepacking of medicines, clinic appointments, waiting time, and coherence. A structural equation model was fit to operationalise Donabedian's theory, using unidirectional, mediation, and reciprocal pathways.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The mediation pathway showed that the relationships between structure, process and outcome represented quality systems in the ICDM model. Structure correlated with process (0.40) and outcome (0.75). Given structure, process correlated with outcome (0.88). Of the 17 dimensions of care in the ICDM model, three structure (equipment, critical drugs, accessibility), three process (professionalism, friendliness and attendance to patients) and three outcome (competence, confidence and coherence) dimensions reflected their intended constructs.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Of the priority dimensions, referrals, defaulter tracing, prepacking of medicines, appointments, and patient waiting time did not reflect their intended constructs. Donabedian's theoretical framework can be used to provide evidence of quality systems in the ICDM model.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ameh</LastName><ForeName>Soter</ForeName><Initials>S</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-8449-6423</Identifier><AffiliationInfo><Affiliation>Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. sote_ameh@yahoo.com.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Community Medicine, Faculty of Medicine, College of Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria. sote_ameh@yahoo.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gómez-Olivé</LastName><ForeName>Francesc Xavier</ForeName><Initials>FX</Initials><AffiliationInfo><Affiliation>Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>The International Network for the Demographic Evaluation of Populations and Their Health in Developing Countries (INDEPTH), Accra, Ghana.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kahn</LastName><ForeName>Kathleen</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>The International Network for the Demographic Evaluation of Populations and Their Health in Developing Countries (INDEPTH), Accra, Ghana.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Umeå Centre for Global Health Research, Epidemiology and Global Health, Umeå University, Umeå, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tollman</LastName><ForeName>Stephen M</ForeName><Initials>SM</Initials><AffiliationInfo><Affiliation>Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>The International Network for the Demographic Evaluation of Populations and Their Health in Developing Countries (INDEPTH), Accra, Ghana.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Umeå Centre for Global Health Research, Epidemiology and Global Health, Umeå University, Umeå, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Klipstein-Grobusch</LastName><ForeName>Kerstin</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>D43 TW008330</GrantID><Acronym>TW</Acronym><Agency>FIC NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016448">Multicenter Study</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>03</Month><Day>23</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMC Health Serv Res</MedlineTA><NlmUniqueID>101088677</NlmUniqueID><ISSNLinking>1472-6963</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>J Natl Med Assoc. 2008 Sep;100(9):1052-8</RefSource><PMID Version="1">18807434</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Lancet. 2009 Sep 12;374(9693):934-47</RefSource><PMID Version="1">19709736</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>BMC Health Serv Res. 2007 Jul 09;7:104</RefSource><PMID Version="1">17620113</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Health Policy Plan. 2016 Sep 1;:null</RefSource><PMID Version="1">27591128</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>BMC Health Serv Res. 2014 Mar 06;14:111</RefSource><PMID Version="1">24602169</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>East Afr Med J. 2000 May;77(5):250-5</RefSource><PMID Version="1">12858915</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Inquiry. 1988 Spring;25(1):173-92</RefSource><PMID Version="1">2966122</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Lancet. 2008 Sep 13;372(9642):893-901</RefSource><PMID Version="1">18790312</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Health Care Poor Underserved. 2014 Nov;25(4):1723-9</RefSource><PMID Version="1">25418238</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>PLoS One. 2011;6(12):e27738</RefSource><PMID Version="1">22194791</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Med Care. 1989 May;27(5):522-36</RefSource><PMID Version="1">2725084</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Stud Fam Plann. 1994 May-Jun;25(3):176-83</RefSource><PMID Version="1">7940622</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Cochrane Database Syst Rev. 2006 Apr 19;(2):CD003318</RefSource><PMID Version="1">16625576</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Am J Clin Nutr. 2011 Dec;94(6):1690S-1696S</RefSource><PMID Version="1">22089433</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>JAMA. 1988 Sep 23-30;260(12):1743-8</RefSource><PMID Version="1">3045356</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Bull World Health Organ. 2007 Nov;85(11):880-5</RefSource><PMID Version="1">18038079</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Health Policy Plan. 2017 Mar 1;32(2):257-266</RefSource><PMID Version="1">28207046</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>BMC Health Serv Res. 2008 Oct 09;8:210</RefSource><PMID Version="1">18844998</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>BMC Health Serv Res. 2009 May 09;9:75</RefSource><PMID Version="1">19426533</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Med Care. 1978 Apr;16(4):327-36</RefSource><PMID Version="1">651398</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Int J Qual Health Care. 1999 Feb;11(1):5-12</RefSource><PMID Version="1">10411284</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Milbank Mem Fund Q. 1966 Jul;44(3):Suppl:166-206</RefSource><PMID Version="1">5338568</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Int J Epidemiol. 2012 Aug;41(4):988-1001</RefSource><PMID Version="1">22933647</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Image J Nurs Sch. 1998;30(1):43-6</RefSource><PMID Version="1">9549940</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>BMC Health Serv Res. 2012 Jul 31;12:228</RefSource><PMID Version="1">22849727</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000553" MajorTopicYN="N">Ambulatory Care</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002908" MajorTopicYN="N">Chronic Disease</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000628" 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UI="D011320" MajorTopicYN="N">Primary Health Care</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011785" MajorTopicYN="N">Quality Assurance, Health Care</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011787" MajorTopicYN="N">Quality of Health Care</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012423" MajorTopicYN="N">Rural Health</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013019" MajorTopicYN="N">South Africa</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011795" MajorTopicYN="N">Surveys and Questionnaires</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Avedis donabedian</Keyword><Keyword MajorTopicYN="N">Chronic communicable diseases</Keyword><Keyword MajorTopicYN="N">Constructs</Keyword><Keyword MajorTopicYN="N">Integrated Chronic Disease Management (ICDM) Model</Keyword><Keyword MajorTopicYN="N">Mpumalanga province</Keyword><Keyword MajorTopicYN="N">Non-communicable chronic diseases</Keyword><Keyword MajorTopicYN="N">Primary Health Care (PHC)</Keyword><Keyword MajorTopicYN="N">Quality of care</Keyword><Keyword MajorTopicYN="N">Satisfaction</Keyword><Keyword MajorTopicYN="N">South Africa</Keyword><Keyword MajorTopicYN="N">Structural equation model</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year><Month>04</Month><Day>15</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2017</Year><Month>03</Month><Day>18</Day></PubMedPubDate><PubMedPubDate 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