Original Research

The pros and cons of the implementation of a Chronic Care Model in European Rural Primary Care: the points of view of European Rural General Practitioners

AUTHORS

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Donata Kurpas1
MD, PhD, Professor *

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Ferdinando Petrazzuoli2
MD, PhD, Physician

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Katarzyna Szwamel3
MSc, PhD, Academic Teacher

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Jane Randall-Smith4
Executive Secretary

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Beata Blahova5
MD, General Practitioner

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Gindrovel Dumitra6
MD, PhD, Lecturer

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Kateřina Javorská7
MD, General Practitioner

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András Mohos8
MD, General Practitioner

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José Augusto Simões 9
MD, PhD, Professor

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Victoria Tkachenko 10
MD, PhD, Professor

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Jean-Baptiste Kern11
MD, General Practitioner, Internship Supervisor

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Carol Holland12
PhD, Professor

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Holly Gwyther13
MSc, PhD, Research Fellow

AFFILIATIONS

1 Department of Family Medicine, Wroclaw Medical University, Wroclaw, Poland; and European Rural and Isolated Practitioners Association (EURIPA)

2 Department of Clinical Sciences, Center for Primary Health Care Research, Lund University, Malmö, Sweden; and European Rural and Isolated Practitioners Association (EURIPA)

3 School of Medicine, Opole University, Opole, Poland

4 European Rural and Isolated Practitioners Association (EURIPA)

5 Faculty of Public Health, Slovak Medical University, Bratislava, Slovakia; and European Rural and Isolated Practitioners Association (EURIPA)

6 Romanian National Society of Family Medicine, Bucharest, Romania; Department of Family Medicine, University of Medicine and Pharmacy, Craiova, Romania; and European Rural and Isolated Practitioners Association (EURIPA)

7 Medical Faculty of Hradec Králové, Charles University, Hradec Králové, Czech Republic; and European Rural and Isolated Practitioners Association (EURIPA)

8 Department of Family Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary; and European Rural and Isolated Practitioners Association (EURIPA)

9 Department of Medical Sciences, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; and European Rural and Isolated Practitioners Association (EURIPA)

10 Department of Family Medicine, Institute of Family Medicine at Shupyk National Medical Academy of Postgraduate Education, Kiev, Ukraine; and European Rural and Isolated Practitioners Association (EURIPA)

11 General Practice Department, Faculty of Medicine, Université Grenoble Alpes, Grenoble, France; and European Rural and Isolated Practitioners Association (EURIPA)

12 Centre for Ageing Research, Lancaster University, Lancaster, UK

13 Centre for Ageing Research, Lancaster University, Lancaster, UK; and Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK

ACCEPTED: 24 June 2021


early abstract:

Objective: This paper describes the views of European Rural General Practitioners regarding the strengths, weaknesses, opportunities, and threats of the implementation of a Chronic Care Model (CCM) in European Rural Primary Care.
Design: A mixed-method, online survey.  Data were collected between May and December 2017.  Categorical data were analysed using descriptive methods while free text responses were analysed using qualitative methods.
Setting: Rural primary care in nine European countries (including Central and Eastern Europe).
Participants: 227 General Practitioners
Main outcomes measures: Respondents’ evaluations of a chronic care model in their rural healthcare settings in terms of Strengths, Weaknesses, Opportunities and Threats.
Results: The SWOT analysis revealed that the expertise of healthcare professionals and the strength of relationships and communications between professionals, caregivers and patients are positive components of the CCM system. However, ensuring adequate staffing levels and staff competency are issues that would need to be addressed. Opportunities included the need to enable patients to participate in decision making by ensuring adequate health literacy.
Conclusion: The chronic care model could certainly have benefits for healthcare in rural settings but staffing levels and staff competency would need to be addressed before implementation of CCM in such settings. Improving health literacy amongst patients and their carers will be essential to ensure their full participation in the implementation of a successful CCM.