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Continuity of care in the transition from child to adult diabetes services: a realistic evaluation study

D. Allen, D. Cohen, K. Hood, M. Robling, C. Atwell, C. Lane, L. Lowes, S. Channon, D. Gillespie, S. Groves, J. Harvey, J. Gregory, Samantha Groves

Journal of Health Services Research & Policy, Volume: 17, Issue: 3, Pages: 140 - 148

Swansea University Author: Samantha Groves

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DOI (Published version): 10.1258/jhsrp.2011.011044

Abstract

OBJECTIVES: To identify the continuity mechanisms central to a smooth transition from child to adult diabetes care, the service components through which these can be achieved and their inter-relations in different contexts.METHODS: A realistic evaluation study of five models of transition in England...

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Published in: Journal of Health Services Research & Policy
Published: 2012
URI: https://cronfa.swan.ac.uk/Record/cronfa22179
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2015-06-26T12:16:33.7570574</datestamp><bib-version>v2</bib-version><id>22179</id><entry>2015-06-26</entry><title>Continuity of care in the transition from child to adult diabetes services: a realistic evaluation study</title><swanseaauthors><author><sid>eb642e3823a000ee7550db9c062c2cdb</sid><ORCID/><firstname>Samantha</firstname><surname>Groves</surname><name>Samantha Groves</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2015-06-26</date><deptcode>HHE</deptcode><abstract>OBJECTIVES: To identify the continuity mechanisms central to a smooth transition from child to adult diabetes care, the service components through which these can be achieved and their inter-relations in different contexts.METHODS: A realistic evaluation study of five models of transition in England comprising: organizational analysis (semi-structured interviews with 38 health care professionals and selected observations); case studies of 46 young people under-going transition and 39 carers (three qualitative interviews over a 12-18 month period, medical record review and clinical interviews); surveys of 82 (32% response rate at least once and 11% response rate at two time points) young people in the population approaching, undergoing or less than 12 months post-transition, and their carers (questionnaires included psychosocial outcome measures); and a costs and consequences analysis.RESULTS: Seven continuities contribute to smooth transition: relational, longitudinal, management, informational, flexible, developmental and cultural. Relational, longitudinal, flexible and cultural continuity are the most important. Models with high levels of relational, longitudinal, flexible and cultural continuity achieve smooth transition with relatively informal, low-cost informational and management continuity mechanisms. Models with low levels of relational and longitudinal continuity need to invest in more formal interventions to facilitate management, flexible and informational continuity so that smooth transition is not compromised.CONCLUSIONS: Focusing on continuity mechanisms, their inter-relations and the effectiveness of different constellations of service components in achieving smooth transition has furnished evidence to inform the development of innovative models which build on the logic of these findings but are sensitive to local context. Further studies are needed to confirm the quantitative findings from a broader range of services and patients.</abstract><type>Journal Article</type><journal>Journal of Health Services Research &amp; Policy</journal><volume>17</volume><journalNumber>3</journalNumber><paginationStart>140</paginationStart><paginationEnd>148</paginationEnd><publisher/><keywords/><publishedDay>31</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2012</publishedYear><publishedDate>2012-12-31</publishedDate><doi>10.1258/jhsrp.2011.011044</doi><url/><notes/><college>COLLEGE NANME</college><department>Swansea Centre for Health Economics</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HHE</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2015-06-26T12:16:33.7570574</lastEdited><Created>2015-06-26T12:16:33.7570574</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">School of Health and Social Care</level></path><authors><author><firstname>D.</firstname><surname>Allen</surname><order>1</order></author><author><firstname>D.</firstname><surname>Cohen</surname><order>2</order></author><author><firstname>K.</firstname><surname>Hood</surname><order>3</order></author><author><firstname>M.</firstname><surname>Robling</surname><order>4</order></author><author><firstname>C.</firstname><surname>Atwell</surname><order>5</order></author><author><firstname>C.</firstname><surname>Lane</surname><order>6</order></author><author><firstname>L.</firstname><surname>Lowes</surname><order>7</order></author><author><firstname>S.</firstname><surname>Channon</surname><order>8</order></author><author><firstname>D.</firstname><surname>Gillespie</surname><order>9</order></author><author><firstname>S.</firstname><surname>Groves</surname><order>10</order></author><author><firstname>J.</firstname><surname>Harvey</surname><order>11</order></author><author><firstname>J.</firstname><surname>Gregory</surname><order>12</order></author><author><firstname>Samantha</firstname><surname>Groves</surname><orcid/><order>13</order></author></authors><documents/><OutputDurs/></rfc1807>
spelling 2015-06-26T12:16:33.7570574 v2 22179 2015-06-26 Continuity of care in the transition from child to adult diabetes services: a realistic evaluation study eb642e3823a000ee7550db9c062c2cdb Samantha Groves Samantha Groves true false 2015-06-26 HHE OBJECTIVES: To identify the continuity mechanisms central to a smooth transition from child to adult diabetes care, the service components through which these can be achieved and their inter-relations in different contexts.METHODS: A realistic evaluation study of five models of transition in England comprising: organizational analysis (semi-structured interviews with 38 health care professionals and selected observations); case studies of 46 young people under-going transition and 39 carers (three qualitative interviews over a 12-18 month period, medical record review and clinical interviews); surveys of 82 (32% response rate at least once and 11% response rate at two time points) young people in the population approaching, undergoing or less than 12 months post-transition, and their carers (questionnaires included psychosocial outcome measures); and a costs and consequences analysis.RESULTS: Seven continuities contribute to smooth transition: relational, longitudinal, management, informational, flexible, developmental and cultural. Relational, longitudinal, flexible and cultural continuity are the most important. Models with high levels of relational, longitudinal, flexible and cultural continuity achieve smooth transition with relatively informal, low-cost informational and management continuity mechanisms. Models with low levels of relational and longitudinal continuity need to invest in more formal interventions to facilitate management, flexible and informational continuity so that smooth transition is not compromised.CONCLUSIONS: Focusing on continuity mechanisms, their inter-relations and the effectiveness of different constellations of service components in achieving smooth transition has furnished evidence to inform the development of innovative models which build on the logic of these findings but are sensitive to local context. Further studies are needed to confirm the quantitative findings from a broader range of services and patients. Journal Article Journal of Health Services Research & Policy 17 3 140 148 31 12 2012 2012-12-31 10.1258/jhsrp.2011.011044 COLLEGE NANME Swansea Centre for Health Economics COLLEGE CODE HHE Swansea University 2015-06-26T12:16:33.7570574 2015-06-26T12:16:33.7570574 Faculty of Medicine, Health and Life Sciences School of Health and Social Care D. Allen 1 D. Cohen 2 K. Hood 3 M. Robling 4 C. Atwell 5 C. Lane 6 L. Lowes 7 S. Channon 8 D. Gillespie 9 S. Groves 10 J. Harvey 11 J. Gregory 12 Samantha Groves 13
title Continuity of care in the transition from child to adult diabetes services: a realistic evaluation study
spellingShingle Continuity of care in the transition from child to adult diabetes services: a realistic evaluation study
Samantha Groves
title_short Continuity of care in the transition from child to adult diabetes services: a realistic evaluation study
title_full Continuity of care in the transition from child to adult diabetes services: a realistic evaluation study
title_fullStr Continuity of care in the transition from child to adult diabetes services: a realistic evaluation study
title_full_unstemmed Continuity of care in the transition from child to adult diabetes services: a realistic evaluation study
title_sort Continuity of care in the transition from child to adult diabetes services: a realistic evaluation study
author_id_str_mv eb642e3823a000ee7550db9c062c2cdb
author_id_fullname_str_mv eb642e3823a000ee7550db9c062c2cdb_***_Samantha Groves
author Samantha Groves
author2 D. Allen
D. Cohen
K. Hood
M. Robling
C. Atwell
C. Lane
L. Lowes
S. Channon
D. Gillespie
S. Groves
J. Harvey
J. Gregory
Samantha Groves
format Journal article
container_title Journal of Health Services Research & Policy
container_volume 17
container_issue 3
container_start_page 140
publishDate 2012
institution Swansea University
doi_str_mv 10.1258/jhsrp.2011.011044
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care
document_store_str 0
active_str 0
description OBJECTIVES: To identify the continuity mechanisms central to a smooth transition from child to adult diabetes care, the service components through which these can be achieved and their inter-relations in different contexts.METHODS: A realistic evaluation study of five models of transition in England comprising: organizational analysis (semi-structured interviews with 38 health care professionals and selected observations); case studies of 46 young people under-going transition and 39 carers (three qualitative interviews over a 12-18 month period, medical record review and clinical interviews); surveys of 82 (32% response rate at least once and 11% response rate at two time points) young people in the population approaching, undergoing or less than 12 months post-transition, and their carers (questionnaires included psychosocial outcome measures); and a costs and consequences analysis.RESULTS: Seven continuities contribute to smooth transition: relational, longitudinal, management, informational, flexible, developmental and cultural. Relational, longitudinal, flexible and cultural continuity are the most important. Models with high levels of relational, longitudinal, flexible and cultural continuity achieve smooth transition with relatively informal, low-cost informational and management continuity mechanisms. Models with low levels of relational and longitudinal continuity need to invest in more formal interventions to facilitate management, flexible and informational continuity so that smooth transition is not compromised.CONCLUSIONS: Focusing on continuity mechanisms, their inter-relations and the effectiveness of different constellations of service components in achieving smooth transition has furnished evidence to inform the development of innovative models which build on the logic of these findings but are sensitive to local context. Further studies are needed to confirm the quantitative findings from a broader range of services and patients.
published_date 2012-12-31T03:26:24Z
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score 11.036706

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