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Related Experiment Video

Updated: Feb 13, 2026

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Realist evaluation of a complex integrated care programme: protocol for a mixed methods study.

Milawaty Nurjono1, Pami Shrestha2, Alice Lee2

  • 1Centre for Health Services Research and Policy Research, Saw Swee Hock School of Public Health, National University Health System, Singapore.

BMJ Open
|March 4, 2018
PubMed
Summary

This realist evaluation of the National University Health System (NUHS) Regional Health System (RHS) examines how integrated care programs achieve outcomes. Findings will guide the development and scaling of effective, context-specific healthcare interventions.

Keywords:
Integrated CareMixed Methods EvaluationRealist Evaluation

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Area of Science:

  • Healthcare Management
  • Health Services Research
  • Public Health

Background:

  • Complex integrated care programs often lack clear understanding of how they achieve outcomes, hindering development and scaling.
  • Existing evaluation methods struggle to capture the nuances of integrated care, creating research gaps.

Purpose of the Study:

  • To evaluate the National University Health System (NUHS) Regional Health System (RHS) using a theory-driven realist evaluation approach.
  • To examine the mechanisms and contexts through which the NUHS-RHS improves healthcare utilization, outcomes, patient experiences, and reduces costs.

Main Methods:

  • A three-phase realist evaluation: initial program theory development, mixed-methods data collection (context, mechanisms, outcomes), and theory refinement.
  • Utilizing document reviews, stakeholder interviews, and a convergent parallel mixed-method study to gather empirical data.

Main Results:

  • Analysis will follow the Context-Mechanism-Outcome (CMO) configuration to explain program effectiveness.
  • Refined program theory will detail what works, how, and under what conditions within the NUHS-RHS.

Conclusions:

  • This realist evaluation provides a framework for understanding and improving integrated care programs.
  • Findings will inform the development, implementation, and scaling of context-specific, effective healthcare interventions.