Background
Methods
Study design and setting
Partcipants and data collection
Practice member measures
ACIC survey
Professional role of practice members
Practice environment checklist
Patient measures
PACIC
Analytic plan
Results
Primary care patients with 1 or more chronic illnesses (N = 1,886) | |
---|---|
Age in years, mean (SD) | 55.1 (15.2) |
Female (%) | 65.0 |
Ethnicity | |
White non-Hispanic (%) | 39.7 |
Hispanic (%) | 48.7 |
Black (%) | 5.5 |
Other (%) | 6.1 |
Education | |
High school graduate/GED or less (%) | 42.6 |
High school graduate with some college (%) | 31.0 |
College graduate (%) | 26.4 |
Self-rated health, mean (SD) | 3.0 (0.9) |
Practice Members (N = 283)
| |
Physicians (%) | 15.8 |
Non-physician primary care providers (PAs, NPs) | 6.5 |
Direct care staff (%) | 43.7 |
Non-direct care staff (%) | 34.1 |
Practices (N = 39)
| |
Number of providers, M (SD) | 2.17 (1.1) |
Number of non-provider staff, M (SD) | 8.5 (6.8) |
Office Visits per Day per FTE, Mean (SD) | 23.0 (5.5) |
Percentage of Medicaid Patients, M (SD) | 12.3 (16.2) |
Percentage of Medicare Patients, M (SD) | 32.8 (21.5) |
Percentage of White Patients, M (SD) | 28.9 (18.7) |
Percentage of Practices with EMR (%) | 51.3 |
PACIC and ACIC scores
PACIC Scores (N = 1,866) Range of possible scores 0 to 5 | |||
---|---|---|---|
Scale/Subscale | Mean (SD) | α | ICC |
Summary | 3.22 (1.1) | 0.95 | .08 |
Patient Activation/Involvement | 3.39 (1.3) | 0.85 | .07 |
Delivery System Design/Decision support | 3.69 (1.1) | 0.77 | .04 |
Goal-setting/Tailoring | 3.13 (1.3) | 0.86 | .05 |
Problem-solving/Contextual | 3.53 (1.3) | 0.89 | .05 |
Follow-up/Coordination | 2.69 (1.3) | 0.88 | .08 |
ACIC Scores (N = 286) Range of possible Scores 0 to 11
| |||
Scale/Subscale
|
Mean (SD)
|
α
|
ICC
|
Summary | 6.2 (2.1) | 0.94 | .11 |
Decision Support | 6.0 (2.5) | 0.80 | .18 |
Self-management Support | 6.2 (2.4) | 0.84 | .06 |
Community Linkages | 6.1 (2.6) | 0.74 | .10 |
Clinical Information Systems | 5.8 (2.6) | 0.86 | .11 |
Delivery System Design | 6.5 (2.2) | 0.85 | .16 |
Organizational Leadership & Support | 6.8 (2.4) | 0.88 | .16 |
CCM Integration | 6.0 (2.5) | 0.89 | .10 |
Predictors of PACIC
PACIC (Dependent variable) | ||||||
---|---|---|---|---|---|---|
ACIC Predictor | Summary | Patient activation | Delivery system design/Decision support | Goal-setting | Problem-solving | Follow-up/Coordination |
Summary
| .059 (.034)ns
| .057 (.039)ns
| .011 (.031)ns
| .064 (.037)ns
| .056 (.038)ns
| .084 (.039)*
|
.050 (.033)
ns
|
.066 (.036)
ns
|
.011 (.029)
ns
|
.055 (.035)
ns
|
.056 (.036)
ns
|
.076 (.036)
*
| |
Decision support
| .026 (.027)ns
| .035 (.031)ns
| -.010 (.024)ns
| .027 (.029)ns
| .026 (.030)ns
| .042 (.031)ns
|
.030 (.025)
ns
|
.044 (.028)
ns
|
-.007 (.023)
ns
|
.028 (.027)
ns
|
.030 (.029)
ns
|
.045 (.029)
ns
| |
Self-management support
| .084 (.033)*
| .091 (.037)*
| .048 (.030)ns
| .099 (.035)*
| .078 (.037)*
| .084 (.038)*
|
.088 (.032)
*
|
.099 (.034)
*
|
.052 (.028)
ns
|
.099 (.033)
*
|
.081 (.035)
*
|
.088 (.035)
*
| |
Community linkages
| -.082 (.024)**
| -.100 (.028)**
| -.072 (.022)*
| -.088 (.026)**
| -.093 (.027)**
| -.065 (.029)*
|
-.077 (.023)
**
|
-.080 (.027)
**
|
-.069 (.022)
*
|
-.086 (.025)
**
|
-.087 (.026)
**
|
-.066 (.028)
*
| |
Clinical information systems
| .069 (.029)*
| .079 (.033)*
| .012 (.026)ns
| .066 (.031)*
| .068 (.033)*
| .097 (.033)**
|
.060 (.027)
*
|
.073 (.030)
*
|
.009 (.025)
ns
|
.054 (.030)
ns
|
.062 (.032)
ns
|
.086 (.031)
**
| |
Delivery system design
| .108 (.030)**
| .117 (.034)**
| .053 (.027)ns
| .112 (.032)***
| .107 (.034)*
| .132 (.034)**
|
.094 (.028)
**
| .108 (.031)
**
|
.044 (.026)
ns
|
.094 (.031)
**
|
.096 (.032)
*
| .114 (.032)
**
| |
Organizational support
| .101 (.030)***
| .088 (.035)*
| .059 (.028)*
| .119 (.033)**
| .104 (.035)*
| .117 (.035)**
|
.097 (.028)
**
|
.098 (.032)
*
|
.056 (.027)
ns
|
.106 (.031)
*
|
.102 (.033)
*
|
.097 (.034)
**
| |
CCM Integration
| .059 (.028)ns
| .047 (.033)ns
| .017 (.026)ns
| .063 (.031)*
| .062 (.032)*
| .083 (.033)*
|
.053 (.027)
ns
|
.054 (.030)
ns
|
.015 (.025)
ns
|
.051 (.029)
ns
|
.060 (.031)
ns
|
.071 (.031)
*
|