Premium
Connecting the Dots and Merging Meaning: Using Mixed Methods to Study Primary Care Delivery Transformation
Author(s) -
Scammon Debra L.,
TomoaiaCotisel Andrada,
Day Rachel L.,
Day Julie,
Kim Jaewhan,
Waitzman Norman J.,
Farrell Timothy W.,
Magill Michael K.
Publication year - 2013
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12114
Subject(s) - meaning (existential) , medicaid , audit , data collection , focus group , data extraction , computer science , research design , medicine , data science , health care , medline , psychology , sociology , social science , management , anthropology , political science , law , economics , psychotherapist , economic growth
Objective To demonstrate the value of mixed methods in the study of practice transformation and illustrate procedures for connecting methods and for merging findings to enhance the meaning derived. Data Source/Study Setting An integrated network of university‐owned, primary care practices at the U niversity of U tah (Community Clinics or CC s). CC has adopted Care by Design, its version of the Patient Centered Medical Home. Study Design Convergent case study mixed methods design. Data Collection/Extraction Methods Analysis of archival documents, internal operational reports, in‐clinic observations, chart audits, surveys, semistructured interviews, focus groups, Centers for Medicare and Medicaid Services database, and the U tah All Payer Claims Database. Principal Findings Each data source enriched our understanding of the change process and understanding of reasons that certain changes were more difficult than others both in general and for particular clinics. Mixed methods enabled generation and testing of hypotheses about change and led to a comprehensive understanding of practice change. Conclusions Mixed methods are useful in studying practice transformation. Challenges exist but can be overcome with careful planning and persistence.