Touati Nassera, Pineault Raynald, Champagne François, Denis Jean-Louis, Brousselle Astrid, Contandriopoulos André-Pierre, Geneau Robert
École Nationale d'Administration Publique, Groupe de Recherche Interdisciplinaire en Santé (GRIS), Canada.
Direction Santé Publique Montreal, GRIS, Canada.
Evaluation (Lond). 2009 Oct 1;15(4):375-401. doi: 10.1177/1356389009341729.
Based on the example of the evaluation of service organization models, this article shows how a configurational approach overcomes the limits of traditional methods which for the most part have studied the individual components of various models considered independently of one another. These traditional methods have led to results (observed effects) that are difficult to interpret. The configurational approach, in contrast, is based on the hypothesis that effects are associated with a set of internally coherent model features that form various configurations. These configurations, like their effects, are context-dependent. We explore the theoretical basis of the configuration approach in order to emphasize its relevance, and discuss the methodological challenges inherent in the application of this approach through an in-depth analysis of the scientific literature. We also propose methodological solutions to these challenges. We illustrate from an example how a configurational approach has been used to evaluate primary care models. Finally, we begin a discussion on the implications of this new evaluation approach for the scientific and decision-making communities.
基于服务组织模型评估的示例，本文展示了一种构型方法如何克服传统方法的局限性，传统方法大多独立研究各种模型的各个组成部分，导致难以解释的结果（观察到的效应）。相比之下，构型方法基于这样的假设，即效应与一组形成各种构型的内部连贯的模型特征相关联。这些构型与其效应一样，取决于具体情境。我们探讨构型方法的理论基础以强调其相关性，并通过对科学文献的深入分析讨论该方法应用中固有的方法学挑战。我们还针对这些挑战提出了方法学解决方案。我们通过一个示例说明构型方法如何用于评估初级保健模型。最后，我们开始讨论这种新的评估方法对科学界和决策界的影响。
