PDF(Pubmed)
Abstract：
BACKGROUND: Case management (CM) is among the most studied effective models of integrated care for people with complex needs. The goal of this study is to scale up and assess CM in primary healthcare for people with complex needs.
METHODS: The research questions are: (1) which mechanisms contribute to the successful scale-up of CM for people with complex needs in primary healthcare?; (2) how do contextual factors within primary healthcare organisations contribute to these mechanisms? and (3) what are the relationships between the actors, contextual factors, mechanisms and outcomes when scaling-up CM for people with complex needs in primary healthcare? We will conduct a mixed methods Canadian interprovincial project in Quebec, New-Brunswick and Nova Scotia. It will include a scale-up phase and an evaluation phase. At inception, a scale-up committee will be formed in each province to oversee the scale-up phase. We will assess scale-up using a realist evaluation guided by the RAMESES checklist to develop an initial programme theory on CM scale-up. Then we will test and refine the programme theory using a mixed-methods multiple case study with 10 cases, each case being the scalable unit of the intervention in a region. Each primary care clinic within the case will recruit 30 adult patients with complex needs who frequently use healthcare services. Qualitative data will be used to identify contexts, mechanisms and certain outcomes for developing context-mechanism-outcome configurations. Quantitative data will be used to describe patient characteristics and measure scale-up outcomes.
BACKGROUND: Ethics approval was obtained. Engaging researchers, decision-makers, clinicians and patient partners on the study Steering Committee will foster knowledge mobilisation and impact. The dissemination plan will be developed with the Steering Committee with messages and dissemination methods targeted for each audience.
METHODS: The research questions are: (1) which mechanisms contribute to the successful scale-up of CM for people with complex needs in primary healthcare?; (2) how do contextual factors within primary healthcare organisations contribute to these mechanisms? and (3) what are the relationships between the actors, contextual factors, mechanisms and outcomes when scaling-up CM for people with complex needs in primary healthcare? We will conduct a mixed methods Canadian interprovincial project in Quebec, New-Brunswick and Nova Scotia. It will include a scale-up phase and an evaluation phase. At inception, a scale-up committee will be formed in each province to oversee the scale-up phase. We will assess scale-up using a realist evaluation guided by the RAMESES checklist to develop an initial programme theory on CM scale-up. Then we will test and refine the programme theory using a mixed-methods multiple case study with 10 cases, each case being the scalable unit of the intervention in a region. Each primary care clinic within the case will recruit 30 adult patients with complex needs who frequently use healthcare services. Qualitative data will be used to identify contexts, mechanisms and certain outcomes for developing context-mechanism-outcome configurations. Quantitative data will be used to describe patient characteristics and measure scale-up outcomes.
BACKGROUND: Ethics approval was obtained. Engaging researchers, decision-makers, clinicians and patient partners on the study Steering Committee will foster knowledge mobilisation and impact. The dissemination plan will be developed with the Steering Committee with messages and dissemination methods targeted for each audience.
摘要：
背景：病例管理（CM）是针对具有复杂需求的人的综合护理的研究最多的有效模式之一。这项研究的目的是扩大和评估初级医疗保健中具有复杂需求的人的CM。
方法：研究问题是：（1）哪些机制有助于成功扩大初级卫生保健中具有复杂需求的人的CM规模？（2）初级卫生保健组织内的情境因素如何有助于这些机制？（3）参与者之间的关系是什么？上下文因素，mechanismsandoutcomeswhenscaling-upCMforpeoplewithcomplexneedsinprimaryhealthcare?WewillconductamixedmethodsCanadianinterepoinalprojectinQuebec,新不伦瑞克省和新斯科舍省。它将包括扩大阶段和评估阶段。一开始,各省将成立一个扩大委员会，监督扩大阶段。我们将使用由RAMESES清单指导的现实主义评估来评估规模扩大，以开发CM规模扩大的初始计划理论。然后我们将使用混合方法的多案例研究以10个案例来测试和完善程序理论，每种情况都是区域干预的可扩展单元。案件中的每个初级保健诊所将招募30名经常使用医疗保健服务的复杂需求的成年患者。定性数据将用于识别上下文，开发上下文-机制-结果配置的机制和某些结果。定量数据将用于描述患者特征并衡量放大结果。
背景：获得了伦理批准。参与研究人员，决策者,研究指导委员会的临床医生和患者合作伙伴将促进知识动员和影响。传播计划将与指导委员会一起制定，并针对每个受众提供信息和传播方法。
方法：研究问题是：（1）哪些机制有助于成功扩大初级卫生保健中具有复杂需求的人的CM规模？（2）初级卫生保健组织内的情境因素如何有助于这些机制？（3）参与者之间的关系是什么？上下文因素，mechanismsandoutcomeswhenscaling-upCMforpeoplewithcomplexneedsinprimaryhealthcare?WewillconductamixedmethodsCanadianinterepoinalprojectinQuebec,新不伦瑞克省和新斯科舍省。它将包括扩大阶段和评估阶段。一开始,各省将成立一个扩大委员会，监督扩大阶段。我们将使用由RAMESES清单指导的现实主义评估来评估规模扩大，以开发CM规模扩大的初始计划理论。然后我们将使用混合方法的多案例研究以10个案例来测试和完善程序理论，每种情况都是区域干预的可扩展单元。案件中的每个初级保健诊所将招募30名经常使用医疗保健服务的复杂需求的成年患者。定性数据将用于识别上下文，开发上下文-机制-结果配置的机制和某些结果。定量数据将用于描述患者特征并衡量放大结果。
背景：获得了伦理批准。参与研究人员，决策者,研究指导委员会的临床医生和患者合作伙伴将促进知识动员和影响。传播计划将与指导委员会一起制定，并针对每个受众提供信息和传播方法。
