Evaluation of Chronic Disease Management Services in Primary Healthcare Institutions in Huili City: A Cross-Sectional Study Based on the ACIC Scale

Abstract Objective The aim of this study is to evaluate the current capacity of chronic disease management services in primary healthcare institutions in Huili City, Liangshan Yi Autonomous Prefecture, Sichuan Province. The key influencing factors are systematically analyzed, and scientific evidence and policy recommendations are provided to improve chronic disease management at the primary level in ethnic minority regions. Methods This study employed a cross-sectional design to carry out a comprehensive assessment of chronic disease management service capacity across all 24 primary healthcare institutions in Huili City from May to July 2025. The study participants comprised 217 healthcare professionals engaged in chronic disease management within these institutions. Besides, the validated Chinese version of the Assessment of Chronic Illness Care (ACIC) scale was utilized as the evaluation tool, encompassing 7 dimensions and 34 items. A 5-point Likert scale scoring system was employed, yielding total scores ranging from 0 to 374. Higher scores reflected greater capacity for chronic disease management. Descriptive statistics were utilized to compare overall and dimensional scores, while multiple linear regression models were applied to examine factors influencing chronic disease management capacity in the primary healthcare institutions of Huili City. Results: The ACIC scale assessment of chronic disease management capacity in Huili City's primary healthcare institutions demonstrated an overall mean score of 7.79 ± 2.14 (range 0–11) across all dimensions, with dimension-specific scores increasing progressively from decision support (7.60 ± 2.44) and self-management support (7.65 ± 2.39) to community linkage (7.63 ± 2.43), health information system (7.69 ± 2.33), integration (7.83 ± 2.37), delivery system design (7.92 ± 2.29), as well as healthcare organization (7.97 ± 1.98). Multiple linear regression analysis identified female gender (β = −0.792, P = 0.011), age below 35 years (β = −0.566, P = 0.006), and the establishment of dedicated management teams (β = −1.362, P = 0.009) as significant predictors of service capacity, whereas training frequency and education level showed no statistically significant associations (P > 0.05). Conclusions: The assessment illustrated that chronic disease management capacity in Huili City's primary healthcare institutions remains at a moderate level overall. While demonstrating relative strengths in organizational structure (7.97 ± 1.98) and delivery system design (7.92 ± 2.29), significant gaps persist in self-management support (7.65 ± 2.39) and community linkages (7.63 ± 2.43). Moreover, regression analysis identified three key intervention targets: gender-specific workforce optimization (β=−0.792, P = 0.011 for female providers), comprehensive establishment of specialized management teams (β=−1.362, P = 0.009), as well as competency training for community nurses focusing on self-management support. This study presents the first empirical characterization of the "robust infrastructure–fragile service delivery" paradox in chronic disease management within Liangshan Yi Autonomous Prefecture, thereby providing critical evidence to inform health system strengthening in China's ethnic minority regions.