01487nas a2200157   4500000000100000008004100001100001800042700001500060700001300075245013000088250001500218300001100233490000700244520105600251020002201307       2012                            d1 aPatel Anushka1 aMacmahon S1 aRahimi K00aTwo decades of research on innovative models of care delivery for patients with heart failure: the end or just the beginning?  a2012/06/26  a439-450 v153 a<p>
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.
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  a1029-2977 (Print)