Speakers - WNRC2026

Abstract

Background: Integrated care is increasingly recommended as a crucial approach for frail community-dwelling older people, and primary care teams become the optimal providers of this healthcare service. This study aimed to identify the barriers and facilitators to implement integrated care for frail community-dwelling older adults by primary care teams in China. 

Study Design: Qualitative explorative study, using semi-structured interviews and traditional content analysis.

Methods: This qualitative study was conducted from January to May 2024, recruited 20 primary care practitioners and 16 frail older adults through purposive sampling. Participants underwent individual in-depth interviews. The updated Consolidated Framework for Implementation Research and Theoretical Domains Framework were applied to guide interviews, analysis and reporting of findings. 

Results: The findings highlighted 54 implementation determinants of the integrated care for frail individuals, including 26 barriers, 26 facilitators and 2 mixed factors. Common barriers were identified, such as insufficient healthcare human resources, the complexity of integrated care with multiple components, its low priority compared to specific disease treatment, and poor beliefs about capabilities.

Conclusions: The implementation of integrated care is influenced by barriers and facilitators from multiple levels (organizational and individual) and multiple sources (implementers and recipients). It will inform policy makers and practitioners in similar settings of potential strategies to overcome barriers and enhance facilitators, promoting the implementation of integrated care and improving older adults’ quality of life and reducing healthcare costs.

Impact: Guided by the implementation science frameworks, this study identifies 26 barriers, 26 facilitators and 2 mixed factors related to the implementation of integrated care for frail individuals, informing those policy makers and practitioners in similar settings of potential strategies to promote its implementation. It would help promote the large-scale implementation and sustainable development of more integrated care actions in the future, improving the quality of primary healthcare services and promoting universal health coverage and healthy aging.