Developing an integrated care conceptual framework for older adults with multimorbidity within china’s integrated delivery system

Abstract

Background The definition of China’s integrated delivery system remains abstract since it was proposed in 2021, lacking detailed clarification on essential concepts such as specific contents and main providers of services for older adults with multimorbidity. Aim To develop an integrated care conceptual framework for older adults with multimorbidity within China’s integrated delivery system. Methods A scoping review, semi-structured interviews and a modified e-Delphi study were used to explore specific contents of integrated care for older adults with multimorbidity. A social network analysis was conducted to identify healthcare providers with the greatest potential to play a central role in the integrated care for older adults with multimorbidity. Finally, an integrated care conceptual framework was established based on specific contents and main providers. Results The center of the framework represents the people-centered and need-oriented connotation of China’s integrated delivery system. The first circle reflects three significant characteristics of the integrated delivery system, namely care comprehensiveness, care coordination, and care continuity. The second circle includes main providers of integrated care, which are expected to play a central role in professional collaboration and information diffusion. The outermost circle consists of specific contents of integrated care, including clinical practice, human workforce, organisational collaboration, information technology, regulations and policies. Conclusion The framework derived from this study is expected to promote the understanding and implementation of integrated care for older adults with multimorbidity within the Chinese context. The service content of integrated care related to clinical practice also offers valuable references for other countries.