Stratification of elderly with multimorbidity in need of cross-sectoral collaboration: a scoping review: a scoping review

Introduction: Multimorbidity is associated with an increased risk of hospitalization, increased healthcare utilization, fragmentation of care, and higher rates of care transitions (1-3). Cross-sectoral interventions requires time and resource(4). Thus, stratification based on the complexity of patients care needs are required. The aim of this scoping review was to map existing literature on stratification tools for elderly patients with multimorbidity in demand of cross-sectoral care. Methods: Embase, MEDLINE, Cochrane Library, PsycINFO and CINAHL. A search matrix were developed by key knowledge users. All studies were screened on pre-specified eligibility criteria by two independent authors. A concept aggregation was conducted post-hoc to evaluate the slim number of included articles. Results: 3 studies were identified as stratifying patients by the complexity of their disease. The included studies were published between 2015-2018. Studies were conducted in United Kingdom (n=1), United States of America (n=1), and Australia (n=1). Study designs included randomized controlled trial (n=1), case study (n=1) and qualitative research / action research (n=1). A total of 432 participants were included, of which 197 participants were male (45,6%). Conclusion: Stratification tools for identification of elderly patients with multimorbidity in need of cross-sectoral care is currently lacking. However, the eligibility criteria was too slim to provide any meaningful results. We will provide an updated search on stratification tools for elderly with multimorbidity.