TY - JOUR
AU - C. Hudon
AU - A. Lemay-Compagnat
AU - M. Bisson
AU - M. C. Chouinard
AU - G. Moullec
AU - Rodriguez Del Barrio
AU - É Angrignon-Girouard
AU - M. D. Poirier
AU - M. M. Pratte
A1 - 
AB - BACKGROUND: Adults with complex needs require health and social services from a variety of providers. Appropriate care for these people calls for integrated care. However, few studies have assessed the organizational conditions conducive to implementing integrated care programs in preparation for scale-up. OBJECTIVE: This study aimed to 1) implement a case management program as part of an integrated care program initiative for adults with complex needs in health and social services organizations and primary care clinics, 2) evaluate the organizational factors influencing implementation, and 3) share recommendations from key stakeholders to facilitate scale-up. METHODS: A qualitative multiple-case study was conducted in two health and social services organizations and five primary care clinics in Quebec, Canada. We collected data through participant observation, semi-structured interviews, and focus groups with stakeholders. The data were analyzed using deductive (RE-AIM framework) and inductive thematic analysis. Case stories were developed and then compared. RESULTS: Identifying patients targeted by the program was challenging. Better access to health information technology for case-finding was strongly recommended. Remuneration methods compatible with family physicians' expected levels of commitment to the program were needed to promote their engagement. Appropriate change management was also important to promote implementation and ensure sustainability of the program over time. CONCLUSION: This study may inform stakeholders interested in scaling up integrated care programs for adults with complex needs.
AD - Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Pavillon Z10, 27A rue Privee, Sherbrooke, Quebec, J1H 5H3, Canada. Electronic address: catherine.hudon@usherbrooke.ca.; Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Pavillon Z10, 27A rue Privee, Sherbrooke, Quebec, J1H 5H3, Canada. Electronic address: Alexandra.Lemay-Compagnat@USherbrooke.ca.; Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Pavillon Z10, 27A rue Privee, Sherbrooke, Quebec, J1H 5H3, Canada. Electronic address: Mathieu.Bisson2@USherbrooke.ca.; Faculty of Nursing, Université de Montréal, Pavillon Marguerite-d'Youville, 2375 chemin de la Côte Ste-Catherine, Montreal, Quebec, H3T 1A8, Canada. Electronic address: maud.christine.chouinard@umontreal.ca.; School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, 7101 Avenue du Parc, Montreal, Quebec, H3N 1X9, Canada. Electronic address: gregory.moullec@umontreal.ca.; Department of Social Work, Université de Montréal, Pavillon Lionel-Groulx, 3150 rue Jean-Brillant, Montreal, Quebec, H3T 1N8, Canada. Electronic address: lourdes.rodriguez.del.barrio@umontreal.ca.; Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Pavillon Z10, 27A rue Privee, Sherbrooke, Quebec, J1H 5H3, Canada. Electronic address: Emilie.Angrignon-Girouard@USherbrooke.ca.; Patient Partner, Canada Research Chair in Implementing Integrated Care for People with Complex Needs, Université de Sherbrooke, Sherbrooke, Quebec, Canada. Electronic address: Marie-Dominique.Poirier@USherbrooke.ca.; Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Pavillon Z10, 27A rue Privee, Sherbrooke, Quebec, J1H 5H3, Canada. Electronic address: Marie-Mychele.Pratte@USherbrooke.ca.
AN - 40436715
BT - Health Policy
C5 - Healthcare Disparities
DA - Oct
DO - 10.1016/j.healthpol.2025.105321
DP - NLM
ET - 20250418
JF - Health Policy
LA - eng
N2 - BACKGROUND: Adults with complex needs require health and social services from a variety of providers. Appropriate care for these people calls for integrated care. However, few studies have assessed the organizational conditions conducive to implementing integrated care programs in preparation for scale-up. OBJECTIVE: This study aimed to 1) implement a case management program as part of an integrated care program initiative for adults with complex needs in health and social services organizations and primary care clinics, 2) evaluate the organizational factors influencing implementation, and 3) share recommendations from key stakeholders to facilitate scale-up. METHODS: A qualitative multiple-case study was conducted in two health and social services organizations and five primary care clinics in Quebec, Canada. We collected data through participant observation, semi-structured interviews, and focus groups with stakeholders. The data were analyzed using deductive (RE-AIM framework) and inductive thematic analysis. Case stories were developed and then compared. RESULTS: Identifying patients targeted by the program was challenging. Better access to health information technology for case-finding was strongly recommended. Remuneration methods compatible with family physicians' expected levels of commitment to the program were needed to promote their engagement. Appropriate change management was also important to promote implementation and ensure sustainability of the program over time. CONCLUSION: This study may inform stakeholders interested in scaling up integrated care programs for adults with complex needs.
PY - 2025
SN - 0168-8510
SP - 105321
ST - Planning the scale-up of integrated care programs: A qualitative multiple-case study of case management for adults with complex needs in Quebec, Canada
T1 - Planning the scale-up of integrated care programs: A qualitative multiple-case study of case management for adults with complex needs in Quebec, Canada
T2 - Health Policy
TI - Planning the scale-up of integrated care programs: A qualitative multiple-case study of case management for adults with complex needs in Quebec, Canada
U1 - Healthcare Disparities
U3 - 10.1016/j.healthpol.2025.105321
VL - 160
VO - 0168-8510
Y1 - 2025
ER -