Realist evaluation of Belgian pilot projects for paediatric transmural care: protocol for a mixed methods study

Area of Science:

• Healthcare Systems Research
• Pediatric Care Innovation
• Public Health Policy

Background:

• Belgian healthcare is hospital-centered, necessitating a shift towards home-based care.
• Government initiatives support transmural care for chronically ill children to reduce hospitalizations.
• Five pilot projects were selected to explore innovative pediatric care models.

Purpose of the Study:

• To evaluate the effectiveness of transmural care pilot projects for chronically ill children in Belgium.
• To inform the development of new, sustainable models for pediatric care delivery.
• To assess the feasibility and impact of shifting care from hospital to home settings.

Main Methods:

• A mixed-methods realist evaluation guided by the Medical Research Council framework.
• Phased approach: programme theory development, testing, and refinement.
• Data collection includes document review, focus groups (professionals, children, parents, stakeholders), questionnaires, routine data, and budget impact analysis.

Main Results:

• Ongoing evaluation of intervention structure, process, context, and outcomes.
• Analysis will determine alignment with the quintuple aim framework.
• Budget impact analysis will assess project affordability.

Conclusions:

• The study will refine programme theory for transmural pediatric care.
• Findings will provide evidence-based recommendations for future healthcare models.
• Successful implementation could lead to reduced hospital stays and improved patient outcomes.