A realist synthesis of case management for community-dwelling older people: an overview
(2016) 2nd International Conference on Realist Evaluation and Synthesis: Strengthening Principles, Advancing Practice — Location: London (2.October.2016)
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- Abstract
- Case management interventions for older people are complex interventions as they are made of multiple, interacting components and agents and occur in multi-layered social realities. Evaluations of their effectiveness by the means of traditional systematic reviews show inconsistent results. Moreover, they fail to come up with satisfactory explanations about the observed results. The aim of this study was to answer the following questions: What is it about case management for older people that makes it effective or not? For which older people? Under what conditions? Why? We conducted a realist synthesis to identify and understand the mechanisms through which case management could achieve desirable outcomes for this population in different contexts. Primary theory building within a group of experts resulted in a six-stepped sequential framework, oriented by a theory-of-change and guided by the review process. Data were then extracted, analysed and synthesised iteratively through a group of stakeholders. In total, 42 context-mechanism-outcomes configurations were found, refining the initial theories. The results refined the initial theory and showed how the mechanisms can explain the success or failure of case management in its given context. Case management interventions are both the result of and impact the local healthcare system in which they are implemented. This is the reason why the description of the contexts, interacting with case management is so important for this type of analysis.
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Van Durme, T., Billings, J., Cès, S., Schmitz, O., & Macq, J. (2016). A realist synthesis of case management for community-dwelling older people: an overview. 2nd International Conference on Realist Evaluation and Synthesis: Strengthening Principles, Advancing Practice, London. https://hdl.handle.net/2078.5/27300