Abstract
Despite many attempts to evaluate the effectiveness of case management for frail older people, systematic reviews including experimental designs show inconsistent results. Starting from the view that case management is a complex intervention occurring in multilayered realities, we conducted a realist evaluation of case management in Belgium, where this type of intervention is new. Realist approaches are particularly well suited to evaluate complex interventions as they seek to investigate iteratively the literature and empirical data to uncover mid-range theories underpinning the intervention under study. As such, realist evaluations are works in progress which provide tools to describe how, why and for whom an intervention is supposed to work. In this paper, we describe two mid-range theories that can explain why case management can help frail older people to remain at home, through the lens of capacity and social support.
Highlights
IntroductionT. Van Durme et al 864 the co-existence of two or more chronic conditions [1] and involves receiving care from different healthcare professionals such as general practitioners, home care organisations (nurses, nurse assistants, social workers) and medical specialists
Frail older people often have complex care needs, especially when frailty is the result ofT
Starting from the view that case management is a complex intervention occurring in multilayered realities, we conducted a realist evaluation of case management in Belgium, where this type of intervention is new
Summary
T. Van Durme et al 864 the co-existence of two or more chronic conditions [1] and involves receiving care from different healthcare professionals such as general practitioners, home care organisations (nurses, nurse assistants, social workers) and medical specialists. Van Durme et al 864 the co-existence of two or more chronic conditions [1] and involves receiving care from different healthcare professionals such as general practitioners, home care organisations (nurses, nurse assistants, social workers) and medical specialists During exacerbations of their condition or new diagnoses, additional involvement of emergency care and other specialisms may be needed [2]. Allowing older people to stay at home has become a universal aim of health and social care agencies across the Western world, to address the combined factors of growing numbers of frail older people and the strain on the health care budgets Agencies are tackling these problems through the drive for innovative approaches to care. National Voices (2013) offer user-based definitions of integrated care such as “My care is planned with people who work together to understand me and my carer(s), put me in control, co-ordinate and delivery services to achieve my best outcomes” that serve to create a better understanding between service providers and users of integrated care, but are increasingly being used as outcome measures [6]
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