Sociology colloquium: Anna Nieboer (Erasmus University Rotterdam)

Anna Nieboer (Eramus University Rotterdam): Patient-Centered Care: An Example of How the Quality of Chronic Care Predicts Productive Interaction between Patients and Health Care Professionals

The prevalence of chronic diseases that are major causes of death and disability, such as cardiovascular disease (CVD), chronic obstructive pulmonary disease (COPD), and diabetes, is increasing worldwide. Chronically ill patients are currently underdiagnosed and undertreated, and their care rarely incorporates the implementation of primary and secondary preventive measures. Thus, the processes and outcomes of chronic care delivery must be changed, and research findings have strongly suggested that such a transformation requires multicomponent interventions, such as disease management programs based on the chronic care model. We surveyed professionals and patients in 22 disease management programs targeting patients with cardiovascular diseases, chronic obstructive pulmonary disease, heart failure, stroke, comorbidity, psychotic diseases, depression and eating disorders. Patients (n= 4,576 at baseline) and professionals (n= 274 at baseline) were surveyed in 2011 (T1), 2012 (T2) and 2013 (T2). Overall, care quality according to the chronic care model and patients' experiences with chronic illness care delivery significantly improved over time. Furthermore, quality of chronic care delivery at baseline and changes in care delivery quality predicted patients' experiences with chronic care delivery in the long run. Patients' success in coping with chronic illness requires a proactive role and the ability to make productive decisions together with care providers. They share responsibility for chronic illness management, and must also share control over interactions and decisions. We found that (changes in) the quality of chronic care delivery predicted the existence of productive patient-professional interactions over time. The importance of patient-centeredness is growing, and our study exemplifies how quality of chronic care stimulates productive patient-professional interactions.

Anna Nieboer is a professor of Socio-Medical Sciences at the Institute of Health Policy and Management, Erasmus University. In the past decade, her work has focused on quality improvement in long-term care; innovation in health and social care; and the selfmanagement abilities and wellbeing of community-dwelling, frail older people. The author of more than ninety peer-reviewed articles, Nieboer has extensive experience with the evaluation of large-scale, complex, and multidisciplinary interventions. Nieboer holds a master?s degree in sociology from the University of Groningen, the Netherlands, and a doctorate from the same institution upon completing the doctoral program in sociology at the Interuniversity Center for Social Science, Theory, and Methodology.