Can complex health interventions be evaluated using routine clinical and administrative data? - a realist evaluation...

Area of Science:

• Healthcare management
• Public health research
• Health services research

Background:

• Complex interventions for chronic care involve multiple essential components.
• Routine clinical and administrative data are underutilized in evaluating these interventions.

Purpose of the Study:

• To assess the feasibility of using routinely collected data for evaluating complex interventions.
• To demonstrate how a theory-based, realist evaluation approach can improve routine data feasibility.

Main Methods:

• A case study evaluating the chronic care model (CCM) in Finnish primary health care.
• Application of the context-mechanism-outcome (CMO) approach from realist evaluation.
• Utilizing routine data in a naturalistic setting to identify evaluation challenges.

Main Results:

• An experimentalist approach using single-centre routine data is insufficient for evaluating complex interventions.
• The CMO approach provides tools to identify necessary indicators for complex intervention evaluation.

Conclusions:

• The CMO approach enhances the feasibility of using routine data for complex intervention evaluation.
• This method is particularly useful in primary care settings with complex interventions and limited resources for randomization.