Abstract
Background:The iCoach approach to case selection focuses on innovative models of community-based primary healthcare (CBPHC) and their contexts. The aim of this study was to assess the possibilities and limitations of the approach based on Denmark, which differs in significant ways from the jurisdictions initially included.Theory and Methods:Case study research suggests the approach is an interesting attempt to standardise case selection based on literal replication. The study reviewed the national grey literature and interviewed key informants at national and local levels.Results:Applying the approach to Denmark required redefining selection criteria related to collaboration and context to capture its specific institutional and policy context. Selecting cases at the organisational level also required assessing how the system level contexts compared to those of the initial three jurisdictions included in iCoach.Discussion:The iCoach approach allows collecting broadly comparable cases of innovative models of CBPHC across jurisdictions. However, the analysis of underlying conditions of implementing innovative models requires a more interactive approach to case selection.Conclusion:Researchers need to be clearer about the specific purpose of the case selection. This is also highly relevant for practitioners to ensure that insights are applicable in specific local and national contexts.
Highlights
IntroductionThe international research project Implementing integrated care for older adults with complex health needs (iCoach) has developed an approach to case selection for identifying innovative community-based primary healthcare (CBPHC)-models and their specific (country) contexts, based on studies of integrated care [1, 6]
Healthcare systems across industrialised countries have turned to integrating health and social services to address common challenges of providing appropriate, equitable and cost-effective care for growing numbers of older adults with complex needs [1, 2]
The iCoach approach has emerged in close conjunction with case studies conducted in Ontario, Québec and New Zealand [1, 12, 13], but applying the criteria to possible cases to a new jurisdiction can raise broader questions about the possibilities and limitations of a more standardised approach to case selection
Summary
The international research project Implementing integrated care for older adults with complex health needs (iCoach) has developed an approach to case selection for identifying innovative CBPHC-models and their specific (country) contexts, based on studies of integrated care [1, 6]. In many ways, this is similar to the taxonomy of integrated primary care developed by Valentijn and colleagues [7, 8]. We account for the institutional and policy context of community-based primary care in Denmark This is to identify the central ways in which the Danish healthcare system varies from those jurisdictions, which formed the basis for the iCoach approach to case selection. Regions and municipalities are closely connected through a complex system of negotiations and agreements based on the principle of consensus
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