What does integrated care mean from an older person's perspective? A scoping review

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Abstract

Objective To systematically map and synthesise the literature on older adults' perceptions and experiences of integrated care. Setting Various healthcare settings, including primary care, hospitals, allied health practices and emergency departments. Participants Adults aged ≥60 years. Interventions Integrated (or similarly coordinated) healthcare. Primary and secondary outcome measures Using scoping review methodology, four electronic databases (EMBASE, CINAHL, PubMed and ProQuest Dissertation and Theses) and the grey literature (Open Grey and Google Scholar) were searched to identify studies reporting on older adults' experiences of integrated care. Studies reporting on empirical, interpretive and critical research using any type of methodology were included. Four independent reviewers performed study selection, data extraction and analysis. Results The initial search retrieved 436 articles, of which 30 were included in this review. Patients expressed a desire for continuity, both in terms of care relationships and management, seamless transitions between care services and/or settings, and coordinated care that delivers quick access, effective treatment, self-care support, respect for patient preferences, and involves carers and families. Conclusions Participants across the studies desired accessible, efficient and coordinated care that caters to their needs and preferences, while keeping in mind their rights and safety. This review highlights the salience of the relational, informational and organisational aspects of care from an older person's perspective. Findings are transferable and could be applied in various healthcare settings to derive patient-centred success measures that reflect the aspects of integrated care that are deemed important to older adults and their supporters.

Original languageEnglish
Article numbere035157
Number of pages16
JournalBMJ Open
Volume10
DOIs
Publication statusPublished - 22 Jan 2020

Bibliographical note

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial.

Keywords

  • geriatric medicine
  • organisation of health services
  • quality in health care

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