Targeting the ‘right’ patients for integrated care: stakeholder perspectives from a qualitative study

Stokes, J. , Riste, L. and Cheraghi-Sohi, S. (2018) Targeting the ‘right’ patients for integrated care: stakeholder perspectives from a qualitative study. Journal of Health Services Research and Policy, 23(4), (doi: 10.1177/1355819618788100) (PMID:29984592)

Abstract

Objective: To explore the perceptions of relevant stakeholders in terms of targeting the ‘right’ patients for integrated care. Methods: Secondary analysis of qualitative interviews with relevant stakeholders (including programme managers, programme initiators, a representative of the payers, medical and social care professionals and allied health services staff) from two integrated care sites in England. A thematic analysis was conducted of cross-cutting themes. Results: Both sites focused on individualized management of ‘high-risk’ patients through multidisciplinary team case management. The data-driven approach to targeting patients, recommended in the policy literature, did not align with stakeholders’ experience of selecting patients in practice. The ‘right’ patients were at lower risk than those recommended by policy, and their complexities were identified as comprising mostly social rather than medical issues. Conclusions: These findings raise timely questions about the individualized management approach. They potentially explain why management of high-risk patients has not been found to be effective using quantitative measures, undermining the assumption that this approach will lead to cost savings. There is a need to expand beyond an individually targeted approach to incorporate prevention and to address social issues.

• Item Type: Articles
• Additional Information: Funding: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This SELFIE project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement no. 634288. The content of this work reflects only the SELFIE groups’ views, and the European Commission is not liable for any use that may be made of the information contained herein. The CLASSIC project was funded by the National Institute for Health Research Health Services and Delivery Research (12/130/33).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Stokes, Dr Jonathan
• Authors: Stokes, J., Riste, L., and Cheraghi-Sohi, S.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
• Journal Name: Journal of Health Services Research and Policy
• Publisher: SAGE Publications
• ISSN: 1355-8196
• ISSN (Online): 1758-1060
• Published Online: 08 July 2018