The growing prevalence of heart failure and the cost associated with its management has become a major burden for most health care systems worldwide.We review the evidence from randomized studies of innovative models of care delivery for patients with heart failure, refer to some of the most influential non-randomized studies, and discuss the implications of the available evidence for practitioners, policy makers and researchers. Acknowledging that the relevance of evidence depends on the user's needs, we conclude that the likely impact of most models of care on health outcomes and resource utilization is likely to be modest. New approaches for design and evaluation are therefore required. Given the dynamic complexity of the health service environments in which any such models of care must be implemented, the future development of innovative models of care delivery would benefit from closer collaboration between service users, providers, policy makers and multi-disciplinary researchers, as well as more rigorous evaluation.
AD - George Centre for Healthcare Innovation, University of Oxford, Oxford, UK, Department of Cardiovascular Medicine, University of Oxford, Oxford, UK,Oxford University Hospitals NHS Trust, Department of Cardiology, Oxford, UK. AN - 22724882 BT - Archives of Iranian Medicine DP - NLM ET - 2012/06/26 LA - eng M1 - 7 N1 - Rahimi, KazemPatel, AnushkaMacmahon, StephenIranArch Iran Med. 2012 Jul;15(7):439-45. N2 -The growing prevalence of heart failure and the cost associated with its management has become a major burden for most health care systems worldwide.We review the evidence from randomized studies of innovative models of care delivery for patients with heart failure, refer to some of the most influential non-randomized studies, and discuss the implications of the available evidence for practitioners, policy makers and researchers. Acknowledging that the relevance of evidence depends on the user's needs, we conclude that the likely impact of most models of care on health outcomes and resource utilization is likely to be modest. New approaches for design and evaluation are therefore required. Given the dynamic complexity of the health service environments in which any such models of care must be implemented, the future development of innovative models of care delivery would benefit from closer collaboration between service users, providers, policy makers and multi-disciplinary researchers, as well as more rigorous evaluation.
PY - 2012 SN - 1029-2977 (Print) SP - 439 EP - 45 T2 - Archives of Iranian Medicine TI - Two decades of research on innovative models of care delivery for patients with heart failure: the end or just the beginning? VL - 15 ER -