Interventions to improve chronic illness care: evaluating their effectiveness

Three overlapping initiatives can be found in the effort to improve the management of chronic illness: the report card initiative, the disease management industry, and "Improving Chronic Illness Care." The third of these initiatives proposes the Chronic Care Model to assist provider organizations in chronic care improvement. The Chronic Care Model is made up of six major elements: community resources, the health care system surrounding the provider organization, patient self-management, decision support, delivery system redesign, and clinical information systems. Within these elements are a number of components, for example, clinical practice guidelines, reminder prompts, disease registries, provider feedback systems, primary care teams, planned chronic care visits, and case management. A literature review is provided to summarize the effectiveness of these Chronic Care Model components.