General Practice Care in Residential Aged Care Homes: A Systematic Scoping Review

IF 2.3 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Kate H. Marshall, Mary A. Burns, Diane L. Riddiford-Harland, Christopher J. Poulos, Roslyn G. Poulos, Andrew Montague, Ebony T. Lewis, Russell Pearson, Joel J. Rhee
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Abstract

The growing population of older adults residing in Australian residential aged care homes (RACHs) is driving an increased demand for general practitioner (GP) involvement to meet their complex healthcare needs. This scoping review sought to synthesise the evidence on general practice care models implemented within RACHs over the past decade (2013–2023), assessing their structure, effectiveness and implications for Australia’s future healthcare strategies. Employing the Joanna Briggs Institute Scoping Review Methodology, the review systematically searched for English-language studies from five major databases (MEDLINE, EMBASE, CINHAL, Scopus, and PsycINFO) and grey literature, focussing on preventive, management and acute care services for RACH residents aged ≥ 65 and Aboriginal and Torres Strait Islander peoples aged ≥ 50 within comparable healthcare contexts. Following screening, 10 studies were identified, with half conducted in Australia. Models primarily included government or provider-employed GPs and team-based approaches led by registered nurses or nurse practitioners. Despite structural variations, common elements across models were regular GP consultations, co-located services and multidisciplinary partnerships. Three studies reported differing impacts of general practice models on resident health outcomes; provider-based GPs generally reduced unplanned hospital and emergency visits, whereas nurse practitioner–led teams resulted in a slight increase. Both GP-led and team-based models reported broad adoption and acceptance, though cost-effectiveness varied. Despite identifying several promising models, the existing evidence is insufficient for a comprehensive evaluation of their long-term effects on patient health and the broader healthcare system. This underscores the urgent need for further research to develop effective, culturally sensitive and economically sustainable aged care practices, ensuring high-quality care for Australia’s rapidly ageing population.

Abstract Image

安老院舍的全科护理:系统范围检讨
居住在澳大利亚养老院(RACHs)的老年人人口不断增长,这推动了对全科医生(GP)参与的需求增加,以满足他们复杂的医疗保健需求。这一范围审查旨在综合过去十年(2013-2023年)在乡村地区实施的全科护理模式的证据,评估其结构、有效性和对澳大利亚未来医疗保健战略的影响。采用乔安娜布里格斯研究所范围评价方法,系统地检索了五个主要数据库(MEDLINE, EMBASE, CINHAL, Scopus和PsycINFO)和灰色文献中的英语研究,重点关注65岁以上的RACH居民和50岁以上的原住民和托雷斯海峡岛民在可比较的医疗保健背景下的预防、管理和急性护理服务。筛选后,确定了10项研究,其中一半在澳大利亚进行。模式主要包括政府或供应商雇用的全科医生和以团队为基础的方法,由注册护士或执业护士领导。尽管存在结构上的差异,但不同模式的共同要素是定期全科医生会诊、同址服务和多学科合作。三项研究报告了全科医疗模式对居民健康结果的不同影响;以提供者为基础的全科医生通常会减少计划外的医院和急诊就诊,而由执业护士领导的团队则会略微增加。尽管成本效益各不相同,但以gp为主导的模式和以团队为基础的模式都被广泛采用和接受。尽管确定了几个有希望的模型,现有的证据不足以全面评估它们对患者健康和更广泛的医疗保健系统的长期影响。这强调了迫切需要进一步研究,以开发有效的,文化敏感的和经济上可持续的老年护理实践,确保高质量的护理澳大利亚的快速老龄化人口。
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来源期刊
CiteScore
4.50
自引率
8.30%
发文量
423
期刊介绍: Health and Social Care in the community is an essential journal for anyone involved in nursing, social work, physiotherapy, occupational therapy, general practice, health psychology, health economy, primary health care and the promotion of health. It is an international peer-reviewed journal supporting interdisciplinary collaboration on policy and practice within health and social care in the community. The journal publishes: - Original research papers in all areas of health and social care - Topical health and social care review articles - Policy and practice evaluations - Book reviews - Special issues
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