The chronic care model: which physician practice organizations adapt best?

Chronic diseases remain among the major causes of death and disability in Canada as well as in other western industrialized nations. The episodic, punctuated, acute care model of health service delivery that describes the organization and orientation of care delivery is ill prepared to meet the needs of society burdened by chronic illness. The chronic care model (CCM) has been advanced as a way by which primary care practices can be transformed to meet the challenge of chronic illness. The objective of this research is to examine how well primary care physician practices, including walk-in clinics, solo family practices, group family practices, community health centres and physicians practicing in primary care networks, are succeeding at implementing the components of the CCM. Results suggest that physician primary care practices have considerable way to go in implementing the model, with walk-in clinics and solo family practices showing the least progress in inculcating its components.