Integrated Chronic Disease Management Model Improves Quality of Patient Care
Dr Ozayr Mahomed, UKZN’s Academic Coordinator-Graduate Programme in Public Health, received a PhD in Public Health Medicine for his thesis titled: “The Implementation and Sustainability of an Integrated Chronic Disease Management Model (ICDM) at Primary Healthcare Level in South Africa”.
The study aimed to develop an active implementation model and assess its sustainability at primary care level and also to simultaneously assess the effect of the ICDM model on operational efficiency and quality of clinical care to determine the sustainability of the ICDM model from an implementation perspective.
The study was initiated across 42 PHC clinics in three districts: Bushbuckridge sub-district (Ehlanzeni District) in Mpumalanga; Dr Kenneth Kaunda District in the North West, and the West Rand Health District in Gauteng.
The result showed 93%, 81% and 75% of the ICDM-initiating facilities in the West Rand Health District in Bushbuckridge and the Dr Kenneth Kaunda district were fully engaged with the implementation of the model.
Research results have the potential to improve the operational efficiencies and quality of clinical records for patients with chronic diseases at primary healthcare (PHC) clinics in South Africa.
‘Median waiting times for all patients irrespective of diagnosis declined significantly at 38% (14) of the facilities at 12-month and 24-month post intervention, whilst the median waiting times for patients with chronic conditions declined at 26% of the facilities at 12-month and 24-month post intervention,’ said Mahomed.
He said there was a significant increase in the percentage of clinical records for HIV patients on antiretroviral treatment and patients with non-communicable diseases (hypertension and diabetes) between the baseline and six-month post intervention that achieved compliance with the minimum criteria for a record of acceptable standard.
The findings of the study indicated that the model was sustainable with Bushbuckridge having the highest mean sustainability score followed by the West Rand Health District and the Dr Kenneth Kaunda district.
‘The results and lessons from the initial implementation emanating from this study have been beneficial to patients and healthcare providers resulting in the National Department of Health escalating the model across all 52 districts in South Africa,’ he said.
Mahomed said this would be expanded to the Integrated Clinical Services Model and form the backbone of health service delivery at primary care level for the Ideal Clinic initiative of the National Department of Health.