Integrated primary care and social services for older adults with multimorbidity in England: a scoping review

Abstract Background As the prevalence of older adults with multimorbidity increases, greater integration of services is necessary to manage the physical and psycho-social needs of this cohort. This study describes and summarises current evidence, clinical provision and progress towards integrated pr...

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Autores principales:	Hajira Dambha-Miller, Glenn Simpson, Lucy Hobson, Paul Roderick, Paul Little, Hazel Everitt, Miriam Santer
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Integrated care Older adults Multimorbidity England Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/357b1786a26444f6a0d5fb47b1d9d502
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spelling	oai:doaj.org-article:357b1786a26444f6a0d5fb47b1d9d5022021-12-05T12:07:39ZIntegrated primary care and social services for older adults with multimorbidity in England: a scoping review10.1186/s12877-021-02618-81471-2318https://doaj.org/article/357b1786a26444f6a0d5fb47b1d9d5022021-12-01T00:00:00Zhttps://doi.org/10.1186/s12877-021-02618-8https://doaj.org/toc/1471-2318Abstract Background As the prevalence of older adults with multimorbidity increases, greater integration of services is necessary to manage the physical and psycho-social needs of this cohort. This study describes and summarises current evidence, clinical provision and progress towards integrated primary care and social services for older adults with multimorbidity in England. Methods A scoping review was conducted involving systematic searches of a range of electronic academic and policy databases. Articles were screened and extracted in duplicate by two independent reviewers. Data were extracted onto a charting sheet and thematic synthesis was used to summarise findings. Articles were included if published in English and related to primary care, social care and multimorbidity in older adults in England. Conceptually, the review was framed using the Rainbow Model of Integrated Care. Results The search yielded 7656 articles of which 84 were included. Three themes were identified: (1) a focus on individual level services rather than multi-level or multi-sector integration, with an increasing emphasis on the need to consider broader determinants of population health as critical to integrated care for older adults with multimorbidity; (2) the need for policymakers to allow time for integration to embed, to enable new structures and relationships to develop and mature; and (3) the inherent tension between top-down and bottom-up driven approaches to integrated care requires a whole-systems structure, while allowing for local flexibilities. Conclusions There is limited evidence of multi-level and multi-sector integration of services for older adults with multimorbidity in England. The literature increasingly acknowledges wider determinants of population health that are likely to require integration beyond primary care and social services. Improving clinical care in one or two sectors may not be as effective as simultaneously improving the organisation or design across services as one single system of provision. This may take time to establish and will require local input.Hajira Dambha-MillerGlenn SimpsonLucy HobsonPaul RoderickPaul LittleHazel EverittMiriam SanterBMCarticleIntegrated careOlder adultsMultimorbidityEnglandGeriatricsRC952-954.6ENBMC Geriatrics, Vol 21, Iss 1, Pp 1-24 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Integrated care Older adults Multimorbidity England Geriatrics RC952-954.6
spellingShingle	Integrated care Older adults Multimorbidity England Geriatrics RC952-954.6 Hajira Dambha-Miller Glenn Simpson Lucy Hobson Paul Roderick Paul Little Hazel Everitt Miriam Santer Integrated primary care and social services for older adults with multimorbidity in England: a scoping review
description	Abstract Background As the prevalence of older adults with multimorbidity increases, greater integration of services is necessary to manage the physical and psycho-social needs of this cohort. This study describes and summarises current evidence, clinical provision and progress towards integrated primary care and social services for older adults with multimorbidity in England. Methods A scoping review was conducted involving systematic searches of a range of electronic academic and policy databases. Articles were screened and extracted in duplicate by two independent reviewers. Data were extracted onto a charting sheet and thematic synthesis was used to summarise findings. Articles were included if published in English and related to primary care, social care and multimorbidity in older adults in England. Conceptually, the review was framed using the Rainbow Model of Integrated Care. Results The search yielded 7656 articles of which 84 were included. Three themes were identified: (1) a focus on individual level services rather than multi-level or multi-sector integration, with an increasing emphasis on the need to consider broader determinants of population health as critical to integrated care for older adults with multimorbidity; (2) the need for policymakers to allow time for integration to embed, to enable new structures and relationships to develop and mature; and (3) the inherent tension between top-down and bottom-up driven approaches to integrated care requires a whole-systems structure, while allowing for local flexibilities. Conclusions There is limited evidence of multi-level and multi-sector integration of services for older adults with multimorbidity in England. The literature increasingly acknowledges wider determinants of population health that are likely to require integration beyond primary care and social services. Improving clinical care in one or two sectors may not be as effective as simultaneously improving the organisation or design across services as one single system of provision. This may take time to establish and will require local input.
format	article
author	Hajira Dambha-Miller Glenn Simpson Lucy Hobson Paul Roderick Paul Little Hazel Everitt Miriam Santer
author_facet	Hajira Dambha-Miller Glenn Simpson Lucy Hobson Paul Roderick Paul Little Hazel Everitt Miriam Santer
author_sort	Hajira Dambha-Miller
title	Integrated primary care and social services for older adults with multimorbidity in England: a scoping review
title_short	Integrated primary care and social services for older adults with multimorbidity in England: a scoping review
title_full	Integrated primary care and social services for older adults with multimorbidity in England: a scoping review
title_fullStr	Integrated primary care and social services for older adults with multimorbidity in England: a scoping review
title_full_unstemmed	Integrated primary care and social services for older adults with multimorbidity in England: a scoping review
title_sort	integrated primary care and social services for older adults with multimorbidity in england: a scoping review
publisher	BMC
publishDate	2021
url	https://doaj.org/article/357b1786a26444f6a0d5fb47b1d9d502
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Integrated primary care and social services for older adults with multimorbidity in England: a scoping review

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