Causes of care discontinuity in chronic outpatient care: A mixed method case study.

IF 1.6 Q3 HEALTH POLICY & SERVICES Health Services Management Research Pub Date : 2024-12-17 DOI:10.1177/09514848241307183

Anu Vehkamäki, Märt Vesinurm, Riina-Riitta Helminen, Olli Halminen, Paul Lillrank

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Abstract

Background: While health systems are primarily designed for acute health issues, managing life-long conditions often results in chronic care discontinuity. This refers to situations where a chronic patient's planned care fails to actualise.

Research design: This study descriptively explores the reasons behind chronic care discontinuity in outpatient care.

Data collection: Data was collected via interviews and a focus group with healthcare professionals, and a patient survey specifically targeting chronic abdominal patients.

Analysis: Using grounded theorising the Discontinuity of Chronic Care (DoCC) framework was developed, to identify and categorise reasons behind chronic care discontinuity.

Results: The framework reveals that reasons for discontinuity can be largely divided into healthcare system related factors-including caregiver, technological, and process challenges-and patient-related factors such as situational and internal psychological challenges.

Conclusions: The DoCC-framework provides a valuable tool for analysing various patient processes, offering healthcare managers insights to improve the management of chronic patient journeys. Additionally, it guides healthcare professionals to better focus their development efforts on challenges they have the capacity to address.

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慢性病门诊护理中断的原因：混合方法案例研究。

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来源期刊

Health Services Management Research HEALTH POLICY & SERVICES-

CiteScore

4.00

自引率

4.80%

发文量

期刊介绍： Health Services Management Research (HSMR) is an authoritative international peer-reviewed journal which publishes theoretically and empirically rigorous research on questions of enduring interest to health-care organizations and systems throughout the world. Examining the real issues confronting health services management, it provides an independent view and cutting edge evidence-based research to guide policy-making and management decision-making. HSMR aims to be a forum serving an international community of academics and researchers on the one hand and healthcare managers, executives, policymakers and clinicians and all health professionals on the other. HSMR wants to make a substantial contribution to both research and managerial practice, with particular emphasis placed on publishing studies which offer actionable findings and on promoting knowledge mobilisation toward theoretical advances.