Case Management Assessment of a Health Program Implementation
Health assessment belongs to the field of health services research and the knowledge produced aims to improve such services. It can be made from an internal perspective, assessing the effect of the care processes on people’s health, or from an external perspective, considering the impact of actions on the health system and the population epidemiological profile. (Novaes, 2004). Health programs assessment involves the systematic collection of information about the program characteristics, activities and results, which allows analyzing its components, guiding actions for its improvement, justifying the resources used and analyzing its effectiveness (CDC, 2011). The assessment can be of two types: normative appreciation and evaluative research (Champagne, Contandriopoulos, Brouselle, Hartz, et al., 2011; Contandriopoulos et al., 1997). Normative assessment consists of comparing the components of the intervention, structure, activities implemented, and results achieved, with norms and criteria. It makes it possible to produce a judgment of the intervention or program, as well as its components, in relation to the norms and criteria used as reference (Champagne, Hartz, Brouselle, & Contandriopoulos, 2011; Contandriopoulos et al., 1997). Evaluative research aims to analyze the relevance, logic, productivity, effects and efficiency of intervention, configuring six types of analysis: strategic, logic, productivity, effects, efficiency and implementation (Champagne, Contandriopoulos, Brouselle, Hartz, et al., 2011). The implementation analysis aims to identify and understand the context-related factors that interfere with the implementation of an intervention, assessing the degree of implementation and the relationship with the effects produced. This analysis increases the external validity of evaluative research, avoiding the evaluation of the results of an intervention that did not have a satisfactory degree of implementation (Champagne, Brouselle, Hartz, Contandriopoulos, & Denis, 2011; Denis & Champagne, 1997). To evaluate a program it is necessary to describe it clearly, showing how the programmed activities lead to the expected results (CDC, 2011). The description of a program includes the following components: the health problem to be addressed, the groups and organizations involved, the resources used, the activities to be implemented and their products, the intended outcomes and the relationships between activities and outcomes. The Logical Model is the graphical representation of the relationship between program activities and intended outcomes (CDC, 2011).