Causes of care discontinuity in chronic outpatient care : A mixed method case study

Abstract

Background While health systems are primarily designed for acute health issues, managing life-long conditions often results in chronic care discontinuity. This refers to situations where a chronic patient’s planned care fails to actualise. Research Design This study descriptively explores the reasons behind chronic care discontinuity in outpatient care. Data Collection Data was collected via interviews and a focus group with healthcare professionals, and a patient survey specifically targeting chronic abdominal patients. Analysis Using grounded theorising the Discontinuity of Chronic Care (DoCC) framework was developed, to identify and categorise reasons behind chronic care discontinuity. Results The framework reveals that reasons for discontinuity can be largely divided into healthcare system related factors—including caregiver, technological, and process challenges—and patient-related factors such as situational and internal psychological challenges. Conclusions The DoCC-framework provides a valuable tool for analysing various patient processes, offering healthcare managers insights to improve the management of chronic patient journeys. Additionally, it guides healthcare professionals to better focus their development efforts on challenges they have the capacity to address.