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Development of a community-based model for respiratory care services
Emily J Henderson1, Greg P Rubin
1Evaluation, Research and Development Unit, Durham University, School of Medicine and Health, Wolfson Research Institute, Stockton-on-Tees, UK. e.j.henderson@durham.ac.uk
BMC Health Services Research
|July 11, 2012
Summary
This study confirms the Chronic Care Model (CCM) is effective for community-based respiratory care. Experts identified key components and additional elements for optimizing chronic respiratory disease management in community settings.
Area of Science:
- Health Services Research
- Public Health
- Respiratory Medicine
Background:
- Chronic respiratory diseases pose a significant global health burden, increasing mortality and morbidity.
- Community-based care is favored for chronic diseases due to efficiency and patient preference, yet service models are debated.
- Informed commissioning decisions for community-based chronic respiratory disease services are crucial.
Purpose of the Study:
- To identify essential characteristics for a community-based chronic respiratory disease service.
- To inform National Health Service (NHS) commissioning of respiratory care models.
- To validate and refine the Chronic Care Model (CCM) for community respiratory services.
Main Methods:
- The Delphi method was employed for consensus development among experts.
- Components were derived from Wagner's evidence-based Chronic Care Model (CCM).
- The Assessment of Chronic Illness Care tool informed the derivation of standards for each component.
Main Results:
- Eighteen of twenty-one invited experts participated, with high response rates across three Delphi rounds.
- Twelve of the original fifteen CCM components were prioritized for community respiratory care.
- Four new components, related to delivery system design, were identified and agreed upon.
Conclusions:
- The Delphi process validated the CCM as a foundational framework for community respiratory care.
- Key components and additional elements were identified to enhance community-based respiratory services.
- The methodology can be adapted for service redesign in other chronic disease areas.
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