Protocol for a mixed-method analysis of implementation of case management in primary care for frequent users of healthcare services with chronic diseases and complex care needs.
organisation of health services
primary care
protocols and guidelines
qualitative research
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
01 06 2020
01 06 2020
Historique:
entrez:
4
6
2020
pubmed:
4
6
2020
medline:
15
5
2021
Statut:
epublish
Résumé
Case management (CM) in a primary care setting is a promising approach to integrating and improving healthcare services and outcomes for patients with chronic conditions and complex care needs who frequently use healthcare services. Despite evidence supporting CM and interest in implementing it in Canada, little is known about how to do this. This research aims to identify the barriers and facilitators to the implementation of a CM intervention in different primary care contexts (objective 1) and to explain the influence of the clinical context on the degree of implementation (objective 2) and on the outcomes of the intervention (objective 3). A multiple-case embedded mixed-methods study will be conducted on CM implemented in ten primary care clinics across five Canadian provinces. Each clinic will represent a subunit of analysis, detailed through a case history. Cases will be compared and contrasted using multiple analytical approaches. Qualitative data (objectives 1 and 2) from individual semistructured interviews (n=130), focus group discussions (n=20) and participant observation of each clinic (36 hours) will be compared and integrated with quantitative (objective 3) clinical data on services use (n=300) and patient questionnaires (n=300). An evaluation of intervention fidelity will be integrated into the data analysis. This project received approval from the CIUSSS de l'Estrie - CHUS Research Ethic Board (project number MP-31-2019-2830). Results will provide the opportunity to refine the CM intervention and to facilitate effective evaluation, replication and scale-up. This research provides knowledge on how to resp ond to the needs of individuals with chronic conditions and complex care needs in a cost-effective way that improves patient-reported outcomes and healthcare use, while ensuring care team well-being. Dissemination of results is planned and executed based on the needs of various stakeholders involved in the research.
Identifiants
pubmed: 32487584
pii: bmjopen-2020-038241
doi: 10.1136/bmjopen-2020-038241
pmc: PMC7265033
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e038241Subventions
Organisme : CIHR
ID : 397896
Pays : Canada
Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Med J Aust. 2006 Jun 19;184(12):602-6
pubmed: 16803437
PLoS One. 2015 Apr 13;10(4):e0123660
pubmed: 25874866
Fam Med. 2004 Sep;36(8):588-94
pubmed: 15343421
Implement Sci. 2007 Nov 30;2:40
pubmed: 18053122
Implement Sci. 2009 Aug 07;4:50
pubmed: 19664226
BMC Health Serv Res. 2012 Feb 14;12:35
pubmed: 22333434
Res Nurs Health. 2010 Apr;33(2):164-73
pubmed: 20198637
Med Care. 2004 Sep;42(9):851-9
pubmed: 15319610
BMJ Open. 2017 Sep 3;7(9):e017701
pubmed: 28871027
Am J Emerg Med. 2012 Feb;30(2):352-7
pubmed: 21269790
Ann Fam Med. 2019 Sep;17(5):448-458
pubmed: 31501208
J Emerg Med. 2016 Nov;51(5):595-604
pubmed: 27595372
Am J Emerg Med. 2008 Feb;26(2):155-64
pubmed: 18272094
Qual Life Res. 2017 Jan;26(1):149-159
pubmed: 27432251
BMJ Open. 2017 Oct 22;7(10):e017762
pubmed: 29061623
Milbank Q. 1999;77(1):77-110, iv-v
pubmed: 10197028
Acad Emerg Med. 2000 Jun;7(6):637-46
pubmed: 10905642
Health Aff (Millwood). 2011 Dec;30(12):2437-48
pubmed: 22072063
BMJ. 2008 Sep 29;337:a1655
pubmed: 18824488
Eur J Emerg Med. 2013 Oct;20(5):327-34
pubmed: 22960802
Implement Sci. 2016 Feb 24;11:23
pubmed: 26912211
Implement Sci. 2013 Dec 01;8:139
pubmed: 24289295
Ann Emerg Med. 2011 Jul;58(1):41-52.e42
pubmed: 21689565
J Prim Care Community Health. 2018 Jan-Dec;9:2150131917747186
pubmed: 29357748
Perspect Infirm. 2012 Mar-Apr;9(2):34-7
pubmed: 22448436
Acad Emerg Med. 2017 Jan;24(1):40-52
pubmed: 27473387
JAMA. 2009 May 6;301(17):1771-8
pubmed: 19417194
Behav Ther. 2018 Jul;49(4):525-537
pubmed: 29937255
Health Care Manag (Frederick). 2006 Apr-Jun;25(2):155-9
pubmed: 16699330
J Gen Intern Med. 2017 May;32(5):508-515
pubmed: 27400922
BMC Fam Pract. 2018 Jan 9;19(1):11
pubmed: 29316889
Health Res Policy Syst. 2018 Feb 7;16(1):5
pubmed: 29415734
Int J Integr Care. 2013 Mar 22;13:e010
pubmed: 23687482
Health (London). 2013 May;17(3):211-28
pubmed: 22773552
Eff Clin Pract. 1998 Aug-Sep;1(1):2-4
pubmed: 10345255
J Emerg Med. 2013 Mar;44(3):717-29
pubmed: 23200765
Health Econ. 2004 May;13(5):405-15
pubmed: 15127421
Ann Fam Med. 2015 Nov;13(6):523-8
pubmed: 26553891
Cochrane Database Syst Rev. 2015 Mar 03;(3):CD010523
pubmed: 25733495
Eur J Emerg Med. 2016 Oct;23(5):344-50
pubmed: 25969342
BMC Fam Pract. 2015 Feb 06;16:12
pubmed: 25655401
Int Nurs Rev. 2017 Jun;64(2):296-308
pubmed: 27861853
Can Fam Physician. 2002 Oct;48:1654-60
pubmed: 12449550
Ann Emerg Med. 2006 Jul;48(1):1-8
pubmed: 16781914
Ann Fam Med. 2014 Nov-Dec;12(6):573-6
pubmed: 25384822
Trials. 2011 Jun 29;12:163
pubmed: 21714883
Popul Health Manag. 2016 Aug;19(4):248-56
pubmed: 26565379
Value Health. 2005 Sep-Oct;8(5):521-33
pubmed: 16176491
CMAJ. 2000 Apr 4;162(7):1017-20
pubmed: 10763402
BMC Health Serv Res. 2013 Feb 07;13:49
pubmed: 23391214
Front Public Health. 2018 May 18;6:134
pubmed: 29868542
BMJ Open. 2018 Nov 25;8(11):e026433
pubmed: 30478129
Health Qual Life Outcomes. 2005 Sep 01;3:51
pubmed: 16137329