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A Realist Evaluation of Case Management Models for People with Complex Health Conditions Using Novel Methods and Tools—What Works, for Whom, and under What Circumstances?


  • Sue Lukersmith

    (Health Research Institute, University of Canberra, Canberra 2617, Australia
    Lukersmith & Associates, Sydney 2777, Australia
    Centre for Mental Health Research, Australian National University, Canberra 2601, Australia)

  • Luis Salvador-Carulla

    (Health Research Institute, University of Canberra, Canberra 2617, Australia
    Centre for Mental Health Research, Australian National University, Canberra 2601, Australia)

  • Younjin Chung

    (Centre for Mental Health Research, Australian National University, Canberra 2601, Australia)

  • Wei Du

    (School of Public Health, Southeast University, Nanjing 211189, China)

  • Anoush Sarkissian

    (Lukersmith & Associates, Sydney 2777, Australia
    Wellbeing Rehab, Sydney 2112, Australia)

  • Michael Millington

    (Centre for Disability Studies, University of Sydney, Sydney 2006, Australia)


Case management developed from a generalist model to a person-centred model aligned with the evidence-informed evolution of best practice people-centred integrated care. Case management is a multidimensional and collaborative integrated care strategy where the case manager performs a set of interventions/actions to support the person with a complex health condition to progress in their recovery pathway and participate in life roles. It is currently unknown what case management model works in real life for whom and under what circumstances. The purpose of this study was to answer these questions. The study methods used realistic evaluation framework, examined the patterns and associations between case manager actions (mechanisms), the person’s characteristics and environment (context), and recovery (outcomes) over 10 years post severe injury. There was mixed methods secondary analysis of data extracted via in-depth retrospective file reviews ( n = 107). We used international frameworks and a novel approach with multi-layered analysis including machine learning and expert guidance for pattern identification. The study results confirm that when provided, a person-centred case management model contributes to and enhances the person’s recovery and progress towards participation in life roles and maintaining well-being after severe injury.Furthermore, the intensity of case management for people with traumatic brain injury, and the person-centred actions of advising, emotional and motivational support, and proactive coordination contribute to the person achieving their goals. The results provide learnings for case management services on the case management models, for quality appraisal, service planning, and informs further research on case management.

Suggested Citation

  • Sue Lukersmith & Luis Salvador-Carulla & Younjin Chung & Wei Du & Anoush Sarkissian & Michael Millington, 2023. "A Realist Evaluation of Case Management Models for People with Complex Health Conditions Using Novel Methods and Tools—What Works, for Whom, and under What Circumstances?," IJERPH, MDPI, vol. 20(5), pages 1-20, February.
  • Handle: RePEc:gam:jijerp:v:20:y:2023:i:5:p:4362-:d:1083908

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    References listed on IDEAS

    1. Philippa McRae & Conrad Kobel & Sue Lukersmith & Grahame Simpson, 2022. "What Does It Take to Get Somebody Back to Work after Severe Acquired Brain Injury? Service Actions within the Vocational Intervention Program (VIP 2.0)," IJERPH, MDPI, vol. 19(15), pages 1-17, August.
    2. Struckmann, Verena & Leijten, Fenna R.M. & van Ginneken, Ewout & Kraus, Markus & Reiss, Miriam & Spranger, Anne & Boland, Melinde R.S. & Czypionka, Thomas & Busse, Reinhard & Rutten-van Mölken, Mauree, 2018. "Relevant models and elements of integrated care for multi-morbidity: Results of a scoping review," Health Policy, Elsevier, vol. 122(1), pages 23-35.
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