Abstract
Background
Chronic diseases impose a substantial burden on society, and enhancing the quality of chronic disease management in primary care settings has emerged as a policy priority. The Korean government initiated the Primary care Chronic Disease Management Program as a pilot project in 2019, aiming to deliver comprehensive, continuous, and coordinated care to patients with hypertension and diabetes in primary care settings. The purpose of this study was to explore physicians’ experiences during the program implementation.
Method
Semi-structured interviews were conducted with eight physicians who participated in the program, with each interview lasting between 60 to 90 minutes. Thematic analysis was applied to the interview transcripts to generate well-structured and detailed description of data.
Results
The potentials of the program for improving chronic disease management included systematic management of chronic diseases, increased concern on patient education and counselling during consultation, improved therapeutic relationships with patients, and assuming greater responsibility for managing chronic diseases. However, challenges persist in the implementation of the program. These challenges encompass the gap between guidelines and their implementation in real-world settings, time-consuming administrative work, patient's out-of-pocket expenses, and insufficient incentives for fostering a team-based approach. Various contextual challenges were also observed.
Conclusion
While the program has served as a catalyst for enhancing the quality of chronic care by stipulating and incentivizing normative practice guidelines in the current fee-for-service system, substantial challenges still persist, both within the program and beyond.