Exploring the Coordination of Care for People with Multimorbidities and their Support Networks using Social Network Analysis: A Research Protocol

• Published in: International journal of integrated care 2016-12, Vol.16 (6), p.184
• Main Authors: Scholar Caffrey, Orla M, Lee, Mandy S, Molina González, José L, Normand, Charles
• Format: Article
• Language: English
• Subjects: Chronic illnesses; Comorbidity; Health services utilization; Integrated delivery systems; Research methodology; Social network analysis; Social networks; Social support
• ISSN: 1568-4156; 1568-4156
• DOI: 10.5334/ijic.2732

Introduction: Multimorbidity is the presence of two or more chronic conditions within one individual. Continuity of care and appropriate treatment decisions are essential for these individuals in order to avoid adverse outcomes and preventable healthcare costs. People with multimorbidity (_PMM_) can have multiple treatment options and/or require multiple services concurrently, which often is exasperated by fragmented health systems organised to deliver episodic care for single conditions (“disease silos”). Thus, achieving effective integrated care is a particularly complex task for this population. Yet research to date on how care is coordinated for PMMs has been limited, and extant research tend to focus on formal care delivery and seldom accounts for the “hidden” informal care provided by families and communities. There is a need for research that examines how access to care for this population is shaped by clinician-to-clinician and peer-to-peer interactions and how formal and informal care can be integrated.Aims: We aim to gain a better understanding of how care is coordinated for PMMs both formally and informally, and how this influences their access to health services. Study objectives include:1. Illuminate the clinical and social support networks that PMMs have with their healthcare providers and with their families and communities; and identify key individuals that broker care for PMMs within these networks;2. Identify barriers and facilitators that influence PMMs’ access to formal healthcare services3. Evaluate the extent to which PPMs’ clinical and social support networks influence their health service utilisation patterns and health outcomes. An hypothesis is that good PMM care coordination results in better access to services, which may manifest as increased healthcare use compared to those with poor care coordination.Methods: Social network analysis (SNA) is chosen as it facilitates the exploration of social interactions on care coordination:1. Ego-centric SNA. will be performed on a sample of PMMs receiving formal care from a collaborating hospital. Profiles of PMM are being developed based on analysing combinations of chronic illnesses that are most prevalent in Ireland that were captured within “The Irish Longitudinal Study on Ageing” (_TILDA_) datasets. Social support data on PMMs will be collected via a researcher-administered network survey, and respondent-driven sampling will be used to recruit members of PMMs’ informal support networks