Table 4.
Practitioner and patient characteristics influencing integrated care, self-management and health services use for each case.
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CATEGORIES EMERGING CHARACTERISTICS | OUTCOMES | |||||
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CASE A | CASE B | CASE C | CASE D | CASE E | CASE F | |
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Practitioner-level factor | ||||||
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(+) Case manager leadership (skills, attitudes and personal qualities, previous experience, networking) | ↑ access to other healthcare providers; leads to better follow-up and ↓ healthcare use (3) | ↑ patient-centred care and ↑ access to adapted services (1.1) ↑ continuity of care (1.6) ↓ ED visits (because new CTs (3) |
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(+) Provider engagement | ↑ collaboration, communication and exchange of patient’s information between local community health centre and the hospital (1.2) | |||||
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(+) Inter-professional collaboration | ↑ follow-up and a ↑ response to patient needs (1.1) | ↑ sharing and discussion on patient information (1.2) ↓ healthcare use (3) |
↑ access to clear and concise patient information (1.3) ↑ continuity of care and care planning (1.5, 1.6) ↑ consultations with other healthcare professional (patient doesn’t need to repeatedly see doctor for referrals) (3) |
↑ knowledge of patient’s overall situation (1.1) ↑ communication between healthcare professionals (1.2) ↑ patient knowledge of care plan (1.3) ↓ patient repeating their medical history (1.6) ↑ patient appropriate use of resources (3) |
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Patient-level factor | ||||||
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(+) Anxious patient | ↑ patient confidence (given reassurance from case manager) (2) ↓ ED visits (3) |
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(+) Patient with self-management skills | ↑ patient proactivity in their health and healthy lifestyle choices (2) ↓ ED visits (3) |
↑ patient proactivity in their care and healthy lifestyle choices (2) ↓ ED visits (3) |
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CT: care trajectory; ED: emergency department.