Evaluation of the implementation progress through key performance indicators in a new multimorbidity patient-centered care model in Chile

BMC Health Services Research

Research

Teresita Varela¹  Esteban Irazoqui¹  Paulina Muñoz¹  Alvaro Tellez²  Paula Zamorano³  Carolina Rain⁴  Jaime C. Sapag⁵ 

[1] Centro de Innovación en Salud ANCORA UC, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile;Centro de Innovación en Salud ANCORA UC, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile;Department of Family Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile;Centro de Innovación en Salud ANCORA UC, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile;Health Technology Assessment Unit, Center of Clinical Research, Pontificia Universidad Católica de Chile, Santiago, Chile;Current Address: Diagonal Paraguay, 362, Santiago, Chile;Department of Family Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile;Department of Family Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile;Department of Public health, Pontificia Universidad Católica de Chile, Santiago, Chile;Dalla Lana School of Public Health, University of Toronto, Toronto, Canada;

关键词: Multimorbidity;    Key performance indicators;    Implementation;    Progress;    Patient-centered;    Model;   

DOI  :  10.1186/s12913-023-09412-9

 received in 2022-11-03, accepted in 2023-04-17,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundComplex health interventions involve deep organizational, structural, and cultural changes that challenge health teams and decision-makers. The explosion of chronic diseases has made the multimorbidity approach a global priority. The Centro de Innovación en Salud ANCORA UC implemented a Multimorbidity Patient-Centered Care Model in the Chilean public health system.ObjectiveThis study aims to evaluate the progress of the implementation of the Multimorbidity Patient-Centered Care Model in seven primary care centers through key performance indicators.Methodsa set of indicators was designed to evaluate change management, operations, installation of new roles, and services and activities of the intervention strategy of the model. Key performance indicators were identified to monitor the implementation progress on minimal components for the model’s sustainability. Each item was assigned against an expected minimum score of 67% of progress from the overall score. They were monitored twice in seven primary health centers in 2019 and 2020, which intervened 22,642 patients with the intervention.ResultsThe results showed that six of the seven primary care centers reached the minimum implementation threshold. The main advances were in operational conditions, and those with minor progress in implementation were the clinical services. Population size, organization, coordination of the health care teams, additional training, and decision-makers support were key factors that determined the degree of progress in a complex intervention.ConclusionIt was possible to measure the progression of the implementation of a complex intervention through key performance indicators delivering relevant information for decision-makers that pursue a successful and faithful implementation. This study provides a valuable tool for the national scale-up of a similar model started in Chile by the Ministry of Health and other countries.

【 授权许可】

CC BY   
© The Author(s) 2023

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