Realist Research, Design and Evaluation for Integrated Care Initiatives

Realist research and evaluation methods are increasingly being used in health and social care research settings, including integrated care endeavours. The realist view of how the world is, and how we can explain it, seeks to look 'beneath the hood' and to ask the questions how and why. Health and social policy and service settings, within which integrated care strives to make a difference, are complex 'open' systems that can only partially be understood using empirical methods alone. Abductive and retroductive modes of reasoning, as used by realist researchers, are commonly used by physicians, detectives and lawyers to postulate hidden explanations based on available experienced evidence. The approach is, therefore, not foreign to many readers of this chapter, and realist scientific methodology gives validity to this common but scientifically neglected mode of analysis.