Satisfaction with the quality of care in the integrated chronic disease management model in rural South Africa Soter Ameh 1, Xavier Gómez-Olivé 1,2, Kathleen Kahn 1,2,3, Stephen Tollman 1,2,3 Kerstin Klipstein-Grobusch 4,5 Research findings Mean age - 55 years; females - 81%; little (< 6 years) or no formal education - 88%; South Africans - 95% *Priority areas in the ICDM model Conclusions and recommendation The patients and operational managers were not satisfied with patient waiting time in the health facilities The patients were not satisfied with defaulter tracing and appointment systems. We would like the Department of Health to improve service delivery in patient waiting time, defaulter tracing and clinic appointment system. What is this study about? South Africa has a high burden of HIV and other chronic conditions such as hypertension, diabetes and obesity. In response to the chronic disease burden, the National Department of Health initiated the Integrated Chronic Disease Management (ICDM) model in Primary Health Care (PHC) facilities in The ICDM model is part of the PHC re-engineering, which is being piloted in Gauteng, North West and Mpumalanga Provinces in South Africa. The reason for integrating services for all chronic diseases is to pull resources and more efficiently meet patients’ health needs When did this study take place? The study was conducted between June 2013 and June Affiliations of researchers: 1 MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa. 2 INDEPTH Network Accra, Ghana. 3 Umeå Centre for Global Health Research, Epidemiology and Global Health, Umeå University, Umeå, Sweden. 4 Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. 5 Julius Global Health, Julius Center for Health Sciences and Primary Care, Utrecht University Medical Centre, Utrecht, The Netherlands. *Priority areas in the ICDM model † Significant differences in satisfaction between patients and operational managers Acknowledgements: This research was funded by: (i) MRC/Wits Rural Public Health and health Transitions Research Unit (Agincourt) South Africa, through the Wellcome Trust, UK; (ii) African Doctoral Dissertation Research Fellowship Programme and (iii) Fogarty International Center of the National Institutes of Health For further details and inquiries, contact Dr. Soter Ameh at: ; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), P.O. Box 2 Acornhoek, 1360, Mpumalanga Province, South Africa. Who participated in this study? Four hundred and thirty-five (435) patients receiving treatment for HIV, hypertension and diabetes were selected from the seven PHC facilities in the manner that reflected the total number of chronic disease patients attending each health facility. The operational managers of the seven PHC facilities were also recruited for the study. The study participants were asked how satisfied they were with various aspects of quality of care categorised as structure, process and outcome. What is structure, process and outcome? Structure is the professional and organisational resources associated with the provision of health care (e.g., supply of critical medicines and availability of functional equipment) Process refers to the things done to and for the patient (e.g., defaulter tracing and hospital referrals) Outcome is the desired result of care provided by the nurses (e.g., patient waiting time) Where did this study take place? The study was conducted in selected PHC facilities in Bushbuckridge sub- district, Mpumalanga Province. The PHC facilities were Belfast, Justicia, Lillydale, Kildare, Xanthia, Cunningmore A clinics and Agincourt comprehensive health centre. *Priority areas in the ICDM model † Significant differences in satisfaction between patients and operational managers Why did we conduct this study? The purpose of this study was to assess satisfaction of patients and operational managers (nurses-in-charge of health facilities) with various aspects of the quality of care in the ICDM model. Criteria for judging satisfaction The patients and operational managers were judged to be satisfied with the aspects of quality of care in the ICDM model if their satisfaction scores were 50% and above A statistical technique was used to compare the differences in the responses of the patients and those of the operational managers in the various aspects of quality of care in the ICDM model