Applying the Chronic Care Model in a Free Clinic

摘要

Uninsured patients with diabetes are less likely than insured patients to receive recommended care and access the appropriate chronic care management programs, resulting in poorer outcomes. A pilot program using the Chronic Care Model framework was implemented to determine its effectiveness in improving clinical and self-management outcomes of high-risk patients with diabetes attending a free clinic for the uninsured. A comparison of baseline and posttest findings showed a statistically significant reduction in hemoglobin A1c. Although not statistically significant, downward trends were observed in blood pressure, triglycerides, and low-density lipoprotein levels. All patients had documented self-management goals and reported high satisfaction with the program. These findings suggest that programs guided by the Chronic Care Model have the potential to improve clinical outcomes and self-management skills of uninsured patients with diabetes. (c) 2020 Elsevier Inc. All rights reserved.