LAUSR

"Evaluating complex interventions such as integrated care programs can be problematic or fail to identify impacts for several reasons – identifying appropriate controls, isolating impact, and interrelationships between specific interventions. For these and many other reasons, existing evidence about the broad impact of integrated care is inconclusive. We propose to discuss how we are evaluating the complex intervention of the Integrated Care Alliance (ICA) on the Gold Coast, Queensland. The ICA is a joint initiative of Gold Coast Hospital and Health Service and Gold Coast Primary Health Network to create an integrated, coordinated, seamless and streamlined world-class health system that strengthens the link between primary, secondary and tertiary care services to ensure a truly person-centred approach to service delivery. We intend to answer the research question: what are the impacts of the interventions of the ICA, and how have these impacts been achieved? We will report how the research strategy and interventions are both continually adapting in response to formative feedback. We have developed a deliberately broad and iterative research strategy, covering a range of methods and timelines, to triangulate and provide a comprehensive evaluation of the overall impact and the processes associated with those impacts. We consider impact on immediate, medium-term and long-term measurement of utilisation and cost of services, patient outcomes and experiences, and staff experiences and work processes. A fundamental part of the intervention program and its evaluation is to measure and ensure long-term sustainability and the most efficient use of specific program resources. That is, whether the interventions have the capacity and capability to maintain service delivery, sustaining (or improving) health outcomes and experiences as well as containing delivery costs. This will support the ICA to reflect on progress against objectives, situate itself against current evidence and best practice, and identify next steps in its development."