These grants from RWJF supported the planning of its national program to improve the quality of care received by patients with chronic conditions, Improving Chronic Illness Care.
Earlier grants to the Group Health Cooperative of Puget Sound (see the Program Results Reports on ID#s 024739 and 028681 under the Chronic Care Initiatives in HMOs program) had produced a model for effective collaborative management of chronic disease in managed health care.
Under these two planning grants, the project team refined that model, conducted a literature review, published a database of interventions in chronic illness, and surveyed 72 innovative chronic disease management programs by phone and/or through site visits.
Dissemination activities under these planning grants included one book, more than a dozen articles published in journals, and 15 presentations.
The team found three common deficiencies limiting program effectiveness:
- Lack of a population-based perspective for service delivery.
- Weak support for self-management of illness.
- Incomplete implementation, mainly because of physician resistance or inertia.