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Causes of care discontinuity in chronic outpatient care: A mixed method case study
Anu Vehkamäki1, Märt Vesinurm1, Riina-Riitta Helminen2
1Department of Industrial Engineering and Management, Institute of Healthcare Engineering and Management, Aalto University School of Science, Espoo, Finland.
Abstract:
BackgroundWhile health systems are primarily designed for acute health issues, managing life-long conditions often results in chronic care discontinuity. This refers to situations where a chronic patient's planned care fails to actualise.Research DesignThis study descriptively explores the reasons behind chronic care discontinuity in outpatient care.Data CollectionData was collected via interviews and a focus group with healthcare professionals, and a patient survey specifically targeting chronic abdominal patients.AnalysisUsing grounded theorising the Discontinuity of Chronic Care (DoCC) framework was developed, to identify and categorise reasons behind chronic care discontinuity.ResultsThe framework reveals that reasons for discontinuity can be largely divided into healthcare system related factors-including caregiver, technological, and process challenges-and patient-related factors such as situational and internal psychological challenges.ConclusionsThe DoCC-framework provides a valuable tool for analysing various patient processes, offering healthcare managers insights to improve the management of chronic patient journeys. Additionally, it guides healthcare professionals to better focus their development efforts on challenges they have the capacity to address.
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