Relevant Functional Domains from the Integration Framework:
Improving Chronic Illness Care
To evaluate the quality improvement-related strengths and weaknesses of care delivery for chronic illness.
Version 3.5 is a 34-item survey that covers six areas: (1) community linkages, (2) self-management support, (3) decision support, (4) delivery system design, (5) information systems, and (6) organization of care. Questions are divided by area of focus (six areas of chronic illness care) and responses are in the form of a rating scale (levels A-D).
Development and testing:
Instrument development was based on areas of system change suggested by the Chronic Care Model (CCM) that have been shown to influence quality of care. The instrument was tested in 108 organizational teams implementing 13-month-long quality improvement collaboratives in health care systems across the United States. Paired t tests were used to evaluate the sensitivity of the ACIC to detect system improvements. Testing revealed that all six subscale scores were responsive to system improvements made by care teams. In addition, a significant positive relationship between differences in self-reported ACIC scores and a RAND measure of the presence of chronic care model components in care program implementation was found.
Past or validated applications:
- Setting: Health systems with chronic care teams
- Population: Patients with chronic disease
- Level of evaluation: System
- McDonald KM, Schultz E, Albin L, et al. Care Coordination Measures Atlas Update. AHRQ Publication No. 14-0037-EF. Rockville, MD: Agency for Healthcare Research and Quality. June 2014.
- Bonomi AE, Wagner EH, Glasgow RE, et al. Assessment of Chronic Illness Care (ACIC): A practical tool to measure quality improvement. Health Serv Res 2002;37(3):791-820.
- Parchman ML, Zeber JE, Romero RR, et al. Risk of coronary artery disease in type 2 diabetes and the delivery of care consistent with the chronic care model in primary care settings: A STARNet study. Med Care 2007;45(12):1129-34.
- Parchman ML, Pugh JA, Wang CP, et al. Glucose control, self-care behaviors, and the presence of the chronic care model in primary care clinics. Diabetes Care 2007;30(11):2849-54.
- Solberg LI, Crain AL, Sperl-Hillen JM, et al. Care quality and implementation of the chronic care model: A quantitative study. Ann Fam Med 2006;4(4):310-16.
- Sunaert P, Bastiaens H. Feyen L, et al. Implementation of a program for type 2 diabetes based on the Chronic Care Model in a hospital-centered health care system: The Belgian experience. BMC Health Serv Res 2009;9(152).
Copyright 2000, The MacColl Center for Health Care Innovation, Group Health Cooperative.
Additional information can be accessed on the Improving Chronic Illness Web site.