Evidence map›Paper›PMID 34024272›Full record

ArticleBMC health services research2021

Macro and meso level influences on distributed integrated COPD care delivery: a social network perspective.

Wendy Hartford, Sevinj Asgarova, Graham MacDonald, Mary Berger, Sayra Cristancho, Laura Nimmon

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In one paragraph

Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Wendy HartfordDepartment of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, 2211 Wesbrook Mall T325, BC, V6T 2B5, Vancouver, Canada. wendy.hartford@ubc.ca.
Sevinj AsgarovaDepartment of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, 2211 Wesbrook Mall T325, BC, V6T 2B5, Vancouver, Canada.
Graham MacDonaldDepartment of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, 2211 Wesbrook Mall T325, BC, V6T 2B5, Vancouver, Canada.
Mary BergerDepartment of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, 2211 Wesbrook Mall T325, BC, V6T 2B5, Vancouver, Canada.
Sayra CristanchoDepartment of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, 2211 Wesbrook Mall T325, BC, V6T 2B5, Vancouver, Canada.
Laura NimmonDepartment of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, 2211 Wesbrook Mall T325, BC, V6T 2B5, Vancouver, Canada.

Funding

Social Sciences and Humanities Research Council of Canada Insight Development Grant Funding 2018-2020
6 · The paper itself

Abstract

backgroundCare guidelines for people with chronic obstructive pulmonary disease (COPD) recommend an integrated approach for holistic, flexible, and tailored interventions. Continuity of care is also emphasised. However, many patients with COPD experience fragmented care. Discontinuities in healthcare and related social services are likely to result in disjointed rather than integrated care which can negatively affect patient health outcomes. The purpose of this qualitative study was to improve our understanding of, and how, contextual features pertaining to structures and processes of COPD integrated care influence delivery of care within patients' healthcare networks.

methodsWe conducted individual interviews with 28 participants (9 patients, 16 healthcare professionals, and 3 spousal caregivers). Participants were recruited through the lung clinic at a city hospital in western Canada. We employed a social network paradigm to analyse and interpret the data.

resultsThe analysis revealed an overarching theme of fragmented COPD care with two sub-themes: (1) Funding shortfalls and availability of resources, and (2) Dis(mis)connected communication pathways. The overarching theme depicts variations, delays, and discontinuities in patient care. The sub-themes describe how macro level influences and meso level shortfalls were perceived to influence the availability of respiratory care resources that contributed to fragmented COPD care.

conclusionsEmploying a social network lens drew particular attention to family physicians' pivotal role in delivering community-based COPD care. While an integrated approach to care is recommended by care guidelines, institutional and organizational structures and processes, such as financial and communication structures, may inhibit delivery of integrated care. Thus, macro and meso level structures and processes have the potential to shape patient care by constraining family physicians' purposive and communication actions necessary for facilitating an integrated distributed approach to care. We propose a context of care which fosters a context for family physicians' delivery of patient-centered care. Integrated care delivery may improve patients' wellbeing and alleviate financial constraints on the healthcare system.

Indexed as

Delivery of Health Care, IntegratedPulmonary Disease, Chronic ObstructiveCanadaHumansQualitative ResearchSocial NetworkingChronic obstructive pulmonary diseaseDistributed healthcareFamily physicianIntegrated careRespiratory therapistRespirologistSocial networks

Identifiers

PMID34024272
PMCPMC8141100

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.