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A Realist Review of the Home care Literature and its Blind Spots
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  • Damien Contandriopoulos,
  • Kelli Stajduhar,
  • Tanya Sanders,
  • Annie Carrier,
  • Ami Bitschy,
  • Laura Funk
Damien Contandriopoulos
University of Victoria
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Kelli Stajduhar
University of Victoria
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Tanya Sanders
University of Victoria
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Annie Carrier
Université de Sherbrooke
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Ami Bitschy
University of Victoria Institute on Aging & Lifelong Health
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Laura Funk
University of Manitoba
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Abstract

Rationale, aims and objectives: There is a large body of literature from all over the world that describes, analyzes, or evaluates home care models and interventions. The present article aims to identify the practical lessons that can be gained from a systematic examination of that literature. Method: We conducted a three-step sequential search process from which 113 documents were selected. That corpus was then narratively analyzed according to a realist review approach. Results: A first level of observation is that there are multiple blind spots in the existing literature on home care. The definition and delimitation of what constitutes home care services is generally under-discussed. In the same way, the composition of the basket of care provided and its fit with the need of recipients is under-addressed. Finally, the literature relies heavily on RCTs whose practical contribution to decisions or policy is disputable.At a second level, our analysis suggests that three mechanisms (system integration, case management and relational continuity) are core characteristics of home care models effectiveness. Conclusion: We conclude by providing advice for creating effective home care system change through rational and participatory design and evaluation alongside public dialogue about the purpose and future of home care.

Peer review status:IN REVISION

09 Jul 2021Submitted to Journal of Evaluation in Clinical Practice
13 Jul 2021Submission Checks Completed
13 Jul 2021Assigned to Editor
18 Jul 2021Reviewer(s) Assigned
07 Sep 2021Review(s) Completed, Editorial Evaluation Pending
07 Sep 2021Editorial Decision: Revise Major
23 Sep 20211st Revision Received
24 Sep 2021Assigned to Editor
24 Sep 2021Submission Checks Completed