BMJ  2005;330:665-666 (19 March), doi:10.1136/bmj.330.7492.665

Commentary

Trials should inform structures and processes needed for tailoring interventions

¹ Department of Health Systems and Policies, School of Public Health, Université Libre de Bruxelles, CP 597, Route de Lennik 808, 1070 Brussels, Belgium jmacq@ulb.ac.be

The first 150 words of the full text of this article appear below.

Coordinating care for people with multiple needs is inherently complex as it relies strongly on social dynamics at various levels of the health systems. Designing fruitful regulation policies to make care efficient requires a proper systems analysis for tailoring the care model to the context. The SA HealthPlus trial was original for its ambition to test one coordinated care model for people with multiple needs across different chronic conditions and local healthcare systems in South Australia, and it seems to have been tailored realistically to local services and needs.¹ The key elements—targeting patients who need coordinated care, the general practitioner's role as a care coordinator, and a tool for patient self management—have to be tested further in the Southern Australian context. As for similar programmes tested for one chronic condition,² results regarding cost and effectiveness are mixed: the overall implementation of the SA HealthPlus model did not reduce costs, but . . . [Full text of this article]

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