Older multimorbid patients' experiences on integration of services: a systematic review

Lilian Keene Boye*, Christian Backer Mogensen, Tine Mechlenborg, Frans Boch Waldorff, Pernille Tanggaard Andersen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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Abstract

BACKGROUND: Half of the older persons in high-income counties are affected with multimorbidity and the prevalence increases with older age. To cope with both the complexity of multimorbidity and the ageing population health care systems needs to adapt to the aging population and improve the coordination of long-term services. The objectives of this review were to synthezise how older people with multimorbidity experiences integrations of health care services and to identify barriers towards continuity of care when multimorbid.

METHODS: A systematic literature search was conducted in February 2018 by in Scopus, Embase, Cinahl, and Medline using the PRISMA guidelines.

INCLUSION CRITERIA: studies exploring patients' point of view, ≥65 and multi-morbid. Quality assessment was conducted using COREQ. Thematic synthesis was done.

RESULTS: Two thousand thirty studies were identified, with 75 studies eligible for full text, resulting in 9 included articles, of generally accepted quality. Integration of health care services was successful when the patients felt listened to on all the aspects of being individuals with multimorbidity and when they obtained help from a care coordinator to prioritize their appointments. However, they felt frustrated when they did not have easy access to their health providers, when they were not listened to, and when they felt they were discharged too early. These frustrations were also identified as barriers to continuity of care.

CONCLUSIONS: Health care systems needs to adapt to people with multimorbidity and find solutions on ways to create flexible systems that are able to help older patients with multimorbidity, meet their individual needs and their desire to be involved in decisions regarding their care. A Care coordinator may be a solution.

Original languageEnglish
Article number795
JournalBMC Health Services Research
Volume19
Number of pages9
ISSN1472-6963
DOIs
Publication statusPublished - 5. Nov 2019

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Comorbidity
Delivery of Health Care
Health Services
Frustration
Population
Guidelines
Health

Keywords

  • Continuity of care
  • Experiences
  • Integration of services
  • Multimorbidity
  • Older patients'

Cite this

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abstract = "BACKGROUND: Half of the older persons in high-income counties are affected with multimorbidity and the prevalence increases with older age. To cope with both the complexity of multimorbidity and the ageing population health care systems needs to adapt to the aging population and improve the coordination of long-term services. The objectives of this review were to synthezise how older people with multimorbidity experiences integrations of health care services and to identify barriers towards continuity of care when multimorbid.METHODS: A systematic literature search was conducted in February 2018 by in Scopus, Embase, Cinahl, and Medline using the PRISMA guidelines.INCLUSION CRITERIA: studies exploring patients' point of view, ≥65 and multi-morbid. Quality assessment was conducted using COREQ. Thematic synthesis was done.RESULTS: Two thousand thirty studies were identified, with 75 studies eligible for full text, resulting in 9 included articles, of generally accepted quality. Integration of health care services was successful when the patients felt listened to on all the aspects of being individuals with multimorbidity and when they obtained help from a care coordinator to prioritize their appointments. However, they felt frustrated when they did not have easy access to their health providers, when they were not listened to, and when they felt they were discharged too early. These frustrations were also identified as barriers to continuity of care.CONCLUSIONS: Health care systems needs to adapt to people with multimorbidity and find solutions on ways to create flexible systems that are able to help older patients with multimorbidity, meet their individual needs and their desire to be involved in decisions regarding their care. A Care coordinator may be a solution.",
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Older multimorbid patients' experiences on integration of services : a systematic review. / Boye, Lilian Keene; Mogensen, Christian Backer; Mechlenborg, Tine; Waldorff, Frans Boch; Andersen, Pernille Tanggaard.

In: BMC Health Services Research, Vol. 19, 795, 05.11.2019.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Older multimorbid patients' experiences on integration of services

T2 - a systematic review

AU - Boye, Lilian Keene

AU - Mogensen, Christian Backer

AU - Mechlenborg, Tine

AU - Waldorff, Frans Boch

AU - Andersen, Pernille Tanggaard

PY - 2019/11/5

Y1 - 2019/11/5

N2 - BACKGROUND: Half of the older persons in high-income counties are affected with multimorbidity and the prevalence increases with older age. To cope with both the complexity of multimorbidity and the ageing population health care systems needs to adapt to the aging population and improve the coordination of long-term services. The objectives of this review were to synthezise how older people with multimorbidity experiences integrations of health care services and to identify barriers towards continuity of care when multimorbid.METHODS: A systematic literature search was conducted in February 2018 by in Scopus, Embase, Cinahl, and Medline using the PRISMA guidelines.INCLUSION CRITERIA: studies exploring patients' point of view, ≥65 and multi-morbid. Quality assessment was conducted using COREQ. Thematic synthesis was done.RESULTS: Two thousand thirty studies were identified, with 75 studies eligible for full text, resulting in 9 included articles, of generally accepted quality. Integration of health care services was successful when the patients felt listened to on all the aspects of being individuals with multimorbidity and when they obtained help from a care coordinator to prioritize their appointments. However, they felt frustrated when they did not have easy access to their health providers, when they were not listened to, and when they felt they were discharged too early. These frustrations were also identified as barriers to continuity of care.CONCLUSIONS: Health care systems needs to adapt to people with multimorbidity and find solutions on ways to create flexible systems that are able to help older patients with multimorbidity, meet their individual needs and their desire to be involved in decisions regarding their care. A Care coordinator may be a solution.

AB - BACKGROUND: Half of the older persons in high-income counties are affected with multimorbidity and the prevalence increases with older age. To cope with both the complexity of multimorbidity and the ageing population health care systems needs to adapt to the aging population and improve the coordination of long-term services. The objectives of this review were to synthezise how older people with multimorbidity experiences integrations of health care services and to identify barriers towards continuity of care when multimorbid.METHODS: A systematic literature search was conducted in February 2018 by in Scopus, Embase, Cinahl, and Medline using the PRISMA guidelines.INCLUSION CRITERIA: studies exploring patients' point of view, ≥65 and multi-morbid. Quality assessment was conducted using COREQ. Thematic synthesis was done.RESULTS: Two thousand thirty studies were identified, with 75 studies eligible for full text, resulting in 9 included articles, of generally accepted quality. Integration of health care services was successful when the patients felt listened to on all the aspects of being individuals with multimorbidity and when they obtained help from a care coordinator to prioritize their appointments. However, they felt frustrated when they did not have easy access to their health providers, when they were not listened to, and when they felt they were discharged too early. These frustrations were also identified as barriers to continuity of care.CONCLUSIONS: Health care systems needs to adapt to people with multimorbidity and find solutions on ways to create flexible systems that are able to help older patients with multimorbidity, meet their individual needs and their desire to be involved in decisions regarding their care. A Care coordinator may be a solution.

KW - Continuity of care

KW - Experiences

KW - Integration of services

KW - Multimorbidity

KW - Older patients'

U2 - 10.1186/s12913-019-4644-6

DO - 10.1186/s12913-019-4644-6

M3 - Journal article

C2 - 31690308

VL - 19

JO - B M C Health Services Research

JF - B M C Health Services Research

SN - 1472-6963

M1 - 795

ER -