Expanding Performance Measurement to Include Patients’ Experience of Self-Management Support

Pacific Business Group on Health


This is archived content; for historical reference only.

Self-management support plays a key role in chronic disease management, and patients can provide feedback on the most effective provider practices. A CHCF-funded study conducted by the Pacific Business Group on Health correlated patient experience of provider self-management support with process and clinical outcome measures.

The study included more than 150,000 randomly selected patients of 174 medical groups throughout California. Of the patients, 41% (about 61,000 people) indicated they had a chronic condition. The analysis focused mainly on patients with one or more of seven conditions: arthritis, asthma, back pain, cardiovascular disease, depression, diabetes, and hypertension. The purpose of the research was to characterize chronic care performance across California medical groups, identify opportunities for improvement, and contribute to a chronic care performance feedback mechanism for providers.

Among the research findings:

  • On average, about 70% of California patients with chronic conditions reported getting self-management support from their health care providers. The experiences of people with different conditions varied, with diabetes scores significantly higher than the others.
  • Medical practices varied widely in the extent to which they provided self-management support and the specific chronic conditions for which they provided it. Primary care physicians seemed to do a better job for those with arthritis, back pain, and cardiovascular disease, while specialists received better patient experience scores for asthma, diabetes, and hypertension.
  • Providers that used teams to provide self-management support — including nonphysicians such as nurse practitioners, nutritionists, and physical therapists — scored higher than those that did not.

There is evidence of a relationship between providers’ patient self-management support and clinical outcomes for the chronically ill. More work is needed to understand the strength and nature of this relationship.

An executive summary of the research is available under Document Downloads.