Realist evaluation of integrated services to support recovery of hospitalised and non-hospitalised COVID patients

Long-COVID is the term describing the long-term health problems that can result from having a COVID-19 infection. Long-COVID with symptoms beyond 12 weeks affects around 1 in 10 people infect with COVID. It can result in significant health issues, affecting physical, psychological, cognitive, and social health and well-being. Novel approaches that demonstrate integrated primary and acute care systems are needed to support survivors in the community. Symptoms can vary according to severity of initial infection, and can result in serious problems and long-term disability.to support those with long-COVID is highly variable. Structured pathways to support long-COVID patients can help ensure seamless support between community and acute care. We aim to examine the needs of Long-COVID patients who were and were not hospitalised in the acute phase of COVID, and to develop services in response to these needs. We will use ‘realist evaluation’ to do this, a way to understand what works, for whom, when, and why. Realist evaluation is designed to improve understanding about how development interventions/pathways and services work in different contexts.
We will examine the effect of a structured recovery programme (including self-management programmes, early psychological interventions, coordinated specialist COVID GP support, acute and community-based coordinated MDT follow-up). We will also evaluate what services are needed locally, and are practical to provide.
To understand this, we will look at data from our existing services, seeing who is referred and why?
We will examine what symptoms and complications people report, and how this affects their quality of life at different times (3 and 6 months). We will also explore how much these people access healthcare services in the year after infection. We will undertake patient surveys (questionnaires) and interviews to understand unmet needs. We also plan to undertake analysis of costs of health care use and service development.