Integrated health services for older people: A systematic literature review

Background: The framework for integrated person-centered health services provides a public health response to global challenge, the rapid aging of the population. It relies on primary health care in order to be accessible to a large number of patients. However, connections with specialized geriatric care are necessary as well as collaboration between health professionals and social services. Little data exists on the elements required to implement this integrated care. The objective of this work is to identify in the literature the key elements of integrated geriatric care models.
Methods: To this end, a systematic inventory of scientific publications dealing with the integration of care for the elderly was carried out using databases indexed in PubMed in June 2024. The methodological quality of the included studies was assessed using the scale for assessing the quality of studies included in systematic reviews.
Results: Thus, twelve studies were included: systematic reviews (25%), 3 case studies (25%), cohort studies (16.7%), evaluative studies (16.7%), 1 cross-sectional study (8.3%), and observational study (8.3%). The region with the highest number of primary studies was Europe (66.7%), followed by Asia (25%) and America (8.3%). Six articles combined clinical, professional and organizational integration. The most commonly reported elements of these integrated care models were multidisciplinary collaboration, comprehensive assessment, and case management. General practitioners, nurses and social workers were the most frequently mentioned service providers.
Conclusion: Current literature focused predominantly on micro-level clinical integration. However, to meat the needs of aging populations, there is a critical need to generate evidence on meso-organizational and macro-systemic strategies for integrated health services. Strengthening these levels is essential for health systems to deliver person-centered, coordinated care for older persons.