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Delivery of care 

Delivery of care
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date: 30 October 2020

This chapter considers the organization and delivery of care for osteoarthritis (OA) within the broader context of chronic condition management, and with a specific focus on the current OA literature. It describes factors that have influenced healthcare reforms for people with chronic conditions such as OA, and the development and characteristics of chronic condition models of care. The chapter also examines existing models of care for OA, which are commonly multidisciplinary in nature and situated within primary care, community care, or secondary/tertiary care settings. It summarizes current evidence for the effectiveness and cost-effectiveness of OA models of care, acknowledging that limited data are available regarding access and efficiency outcomes. Barriers to the successful development, implementation, and sustainability of OA models of care are discussed, as well as enablers that could facilitate the success of models of care. The chapter also presents points to consider when planning the implementation and evaluation of models of care, such as the development of a program logic, use of theoretical models or frameworks, and careful selection of appropriate research designs (including mixed-methods approaches). Finally, it considers future challenges for OA models of care, particularly the rise of multi-morbidity among patient populations that will necessitate integrated chronic condition management rather than stand-alone OA services. Future models of care may require the design of specific OA modules that can be integrated with generic chronic condition models that address risk behaviour modification and optimize self-management and mental health outcomes.

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