Innovations in Primary Care
October 16, 2002

Improving Primary Care for Patients With Chronic IllnessThe Chronic Care Model, Part 2

Author Affiliations

Author Affiliations: Family and Community Medicine, University of California, San Francisco (Drs Bodenheimer and Grumbach); and MacColl Institute for Healthcare Innovation, Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, Wash (Dr Wagner).


Section Editor: Drummond Rennie, MD, Deputy Editor.

JAMA. 2002;288(15):1909-1914. doi:10.1001/jama.288.15.1909

This article reviews research evidence showing to what extent the chronic care model can improve the management of chronic conditions (using diabetes as an example) and reduce health care costs. Thirty-two of 39 studies found that interventions based on chronic care model components improved at least 1 process or outcome measure for diabetic patients. Regarding whether chronic care model interventions can reduce costs, 18 of 27 studies concerned with 3 examples of chronic conditions (congestive heart failure, asthma, and diabetes) demonstrated reduced health care costs or lower use of health care services. Even though the chronic care model has the potential to improve care and reduce costs, several obstacles hinder its widespread adoption.