Integrated case management between primary care clinics and hospitals for people with complex needs who frequently use healthcare services in Canada

A multiple-case embedded study

Datos Bibliográficos

ID21467904
AutoresCatherine Hudon (0000-0001-6140-9916, Centre Hospitalier Universitaire de Sherbrooke, autor de correspondencia), Maud-Christine Chouinard, Maud‐Christine Chouinard (0000-0001-8114-9146, Université de Montréal), Olivier Dumont‐Samson (Université de Sherbrooke), Olivier Dumont-Samson, Annie-Pier Gobeil-Lavoie (Université du Québec à Chicoutimi), Jean Morneau (Centre Intégré Universitaire de Santé et de Services Sociaux du Saguenay–Lac-Saint-Jean), Mélanie Paradis (Centre Intégré Universitaire de Santé et de Services Sociaux du Saguenay–Lac-Saint-Jean), Yves Couturier (0000-0001-6848-8354, Université de Sherbrooke), Marie-Eve Poitras (0000-0002-3315-0190, Université de Sherbrooke), Thomas G Poder (0000-0001-7017-096X, Université de Montréal), Thomas Poder, Véronique Sabourin (Université du Québec à Chicoutimi), Mireille Lambert (0009-0008-8148-7872, Centre Intégré Universitaire de Santé et de Services Sociaux du Saguenay–Lac-Saint-Jean)
Año2023
Volumen132
Páginas104804
Fecha de publicación2023-06-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaHealth Policy (JOURNAL)
Identificadores de la revistaISSN: 0168-8510 • E-ISSN: 1872-6054
EditorialElsevier BV (PUBLISHER)
DOI10.1016/j.healthpol.2023.104804
PMID37028261
OpenAlexW4362576735
IdiomaEN
Citas recibidas3
Referencias citadas41

INTRODUCTION: Case management (CM) is recognized to improve care integration and outcomes of people with complex needs who frequently use healthcare services, but challenges remain regarding interaction between primary care clinics and hospitals. This study aimed to implement and evaluate an integrated CM program for this population where nurses in primary care clinics worked with a hospital case manager. METHODS: A multiple embedded case study was conducted in the Saguenay-Lac-Saint-Jean region (Québec, Canada), in four dyads including a clinic and a hospital. Mixed data collection included, at baseline and 6 months, interviews and focus groups with stakeholders, patient questionnaires (patient experience of integrated care and self-management), and emergency department (ED) visits in the previous 6 months. RESULTS: Integrated CM implementation was optimal when all stakeholders provided collective leadership, and were supportive of the program, particularly the physicians. The 6-month program enabled the observation of positive qualitative outcomes in most clinic-hospital dyads where implementation occurred. Full implementation was associated with improved care integration. DISCUSSION AND CONCLUSION: Integrated CM between primary care clinics and hospitals is a promising innovation to improve care integration for people with complex needs who frequently use healthcare services. Collective leadership and physicians' buy-in to integrated CM are important to foster the implementation

Business · Emergency department · Family medicine · Focus group · Health care · Integrated care · Chronic Disease Management Strategies · Interprofessional Education and Collaboration · Medicine · Nursing · Primary Care and Health Outcomes