Development of a primary care-based complex care management intervention for chronically ill patients at high risk for hospitalization: a study protocol

Background: Complex care management is seen as an approach to face the challenges of an ageing society with increasing numbers of patients with complex care needs. The Medical Research Council in the United Kingdom has p
Background: Complex care management is seen as an approach to face the challenges of an ageing society with increasing numbers of patients with complex care needs. The Medical Research Council in the United Kingdom has proposed a framework for the development and evaluation of complex interventions that will be used to develop and evaluate a primary care-based complex care management program for chronically ill patients at high risk for future hospitalization in Germany. Methods and design: We present a multi-method procedure to develop a complex care management program to implement interventions aimed at reducing potentially avoidable hospitalizations for primary care patients with type 2 diabetes mellitus, chronic obstructive pulmonary disease, or chronic heart failure and a high likelihood of hospitalization. The procedure will start with reflection about underlying precipitating factors of hospitalizations and how they may be targeted by the planned intervention (pre-clinical phase). An intervention model will then be developed (phase I) based on theory, literature, and exploratory studies (phase II). Exploratory studies are planned that entail the recruitment of 200 patients from 10 general practices. Eligible patients will be identified using two ways of 'case finding': software based predictive modelling and physicians' proposal of patients based on clinical experience. The resulting subpopulations will be compared regarding healthcare utilization, care needs and resources using insurance claims data, a patient survey, and chart review. Qualitative studies with healthcare professionals and patients will be undertaken to identify potential barriers and enablers for optimal performance of the complex care management program. Discussion: This multi-method procedure will support the development of a primary care-based care management program enabling the implementation of interventions that will potentially reduce avoidable hospitalizations.
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Metadaten
Author:Tobias Freund, Michel Wensing, Cornelia Mahler, Jochen Gensichen, Antje Erler, Martin Beyer, Ferdinand M. Gerlach, Joachim Szecsenyi, Frank Peters-Klimm
URN:urn:nbn:de:hebis:30-80718
URL:http://www.implementationscience.com/content/5/1/70
DOI:http://dx.doi.org/doi:10.1186/1748-5908-5-70
ISSN:1748-5908
Parent Title (English):Implementation science
Publisher:BioMed Central
Place of publication:London
Document Type:Article
Language:English
Date of Publication (online):2010/09/21
Date of first Publication:2010/09/21
Publishing Institution:Univ.-Bibliothek Frankfurt am Main
Release Date:2010/10/05
Volume:5
Issue:70
Pagenumber:7
First Page:1
Last Page:7
Note:
© 2010 Freund et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Source:Implementation Science 2010, 5:70 ; doi:10.1186/1748-5908-5-70 ; http://www.implementationscience.com/content/5/1/70
HeBIS PPN:22893172X
Institutes:Medizin
Dewey Decimal Classification:610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 2.0

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