Jiaqi Yu, Huaxin Si, Wendie Zhou, Yang Yang, Yanyan Li, Xue Wang, Hejing Chen, Cuili Wang
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Data analysis was conducted using the Comprehensive Meta‐Analysis software.ResultsThis review included 12 studies involving 6819 community‐dwelling frail older adults from high‐income regions. The results indicated that integrated care had significantly positive effects on frailty and functional ability, but not on social function, hospitalisation, nursing home admission, quality of life, and mortality. Outcomes of caregivers and professionals were rarely reported. The cost‐effectiveness of integrated care has not been confirmed by limited evidence. Few studies have adopted a systematic approach to designing and conducting comprehensive process evaluations guided by scientific frameworks.ConclusionIntegrated care improves frailty and functional ability in community‐dwelling frail older adults but lacks consistent benefits for other outcomes. The lack of evidence on cost‐effectiveness and the caregiver and professional outcomes highlight critical gaps in current research. The absence of systematic process evaluations underscores the need for future studies to adopt rigorous frameworks to assess them.ImpactThis implicates that more research, particularly in underserved regions that lack a high standard of usual medical services, should emphasise the outcomes of caregivers and healthcare professionals, process evaluation, and health economics. Policymakers and practitioners must consider these gaps when implementing integrated care programmes to ensure equitable and sustainable healthcare solutions.Reporting MethodPRISMA 2020 Checklist.Patient or Public ContributionNo patient or public contribution.<jats:styled-content style=\"fixed-case\">PROSPERO</jats:styled-content> Registration NumberCRD42024568811","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"71 1","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effectiveness, Process, and Economic Outcomes of Integrated Care for Community‐Dwelling Frail Older Adults: A Systematic Review and Meta‐Analysis\",\"authors\":\"Jiaqi Yu, Huaxin Si, Wendie Zhou, Yang Yang, Yanyan Li, Xue Wang, Hejing Chen, Cuili Wang\",\"doi\":\"10.1111/jan.70275\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"AimsTo assess the effectiveness, process, and economic outcomes of integrated care for community‐dwelling frail older adults.DesignA systematic review and meta‐analysis.Data SourcesWe searched nine databases, including PubMed, Web of Science, CINAHL, Embase, the Cochrane Library, CNKI, SinoMed, Wanfang, and VIP, three trial registers, grey literature, and reference lists up to April 2024, with an updated search in March 2025.Review MethodsRandomised controlled trials and non‐randomised studies of interventions involving integrated care for community‐dwelling frail older adults were included. Data analysis was conducted using the Comprehensive Meta‐Analysis software.ResultsThis review included 12 studies involving 6819 community‐dwelling frail older adults from high‐income regions. The results indicated that integrated care had significantly positive effects on frailty and functional ability, but not on social function, hospitalisation, nursing home admission, quality of life, and mortality. Outcomes of caregivers and professionals were rarely reported. The cost‐effectiveness of integrated care has not been confirmed by limited evidence. Few studies have adopted a systematic approach to designing and conducting comprehensive process evaluations guided by scientific frameworks.ConclusionIntegrated care improves frailty and functional ability in community‐dwelling frail older adults but lacks consistent benefits for other outcomes. The lack of evidence on cost‐effectiveness and the caregiver and professional outcomes highlight critical gaps in current research. The absence of systematic process evaluations underscores the need for future studies to adopt rigorous frameworks to assess them.ImpactThis implicates that more research, particularly in underserved regions that lack a high standard of usual medical services, should emphasise the outcomes of caregivers and healthcare professionals, process evaluation, and health economics. 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引用次数: 0
摘要
目的评估社区居住体弱老年人综合护理的有效性、过程和经济结果。设计系统评价和荟萃分析。数据来源我们检索了PubMed、Web of Science、CINAHL、Embase、Cochrane Library、CNKI、SinoMed、万方、VIP等9个数据库,检索截止到2024年4月的3个试验注册库、灰色文献和参考文献列表,并于2025年3月更新了检索。综述方法纳入了涉及社区居住体弱老年人综合护理干预措施的随机对照试验和非随机研究。采用综合Meta分析软件进行数据分析。结果本综述纳入了12项研究,涉及6819名来自高收入地区的社区居住体弱老年人。结果表明,综合护理对老年人的虚弱和功能能力有显著的正向影响,但对社会功能、住院率、养老院入院率、生活质量和死亡率没有显著的正向影响。护理人员和专业人员的结果很少报道。综合护理的成本效益尚未得到有限证据的证实。很少有研究采用系统的方法来设计和进行以科学框架为指导的全面过程评价。结论:综合护理可改善社区居住体弱老年人的虚弱和功能能力,但对其他结果缺乏一致的益处。缺乏关于成本效益和护理人员和专业结果的证据,突出了当前研究中的重大差距。由于缺乏系统的过程评价,因此今后的研究需要采用严格的框架来评价它们。这意味着更多的研究,特别是在缺乏高标准常规医疗服务的服务不足地区,应该强调护理人员和卫生保健专业人员的结果、过程评估和卫生经济学。决策者和从业人员在实施综合护理规划时必须考虑到这些差距,以确保公平和可持续的医疗保健解决方案。报告方法prisma 2020核对表。病人或公众捐款:没有病人或公众捐款。普洛斯彼罗注册号crd42024568811
Effectiveness, Process, and Economic Outcomes of Integrated Care for Community‐Dwelling Frail Older Adults: A Systematic Review and Meta‐Analysis
AimsTo assess the effectiveness, process, and economic outcomes of integrated care for community‐dwelling frail older adults.DesignA systematic review and meta‐analysis.Data SourcesWe searched nine databases, including PubMed, Web of Science, CINAHL, Embase, the Cochrane Library, CNKI, SinoMed, Wanfang, and VIP, three trial registers, grey literature, and reference lists up to April 2024, with an updated search in March 2025.Review MethodsRandomised controlled trials and non‐randomised studies of interventions involving integrated care for community‐dwelling frail older adults were included. Data analysis was conducted using the Comprehensive Meta‐Analysis software.ResultsThis review included 12 studies involving 6819 community‐dwelling frail older adults from high‐income regions. The results indicated that integrated care had significantly positive effects on frailty and functional ability, but not on social function, hospitalisation, nursing home admission, quality of life, and mortality. Outcomes of caregivers and professionals were rarely reported. The cost‐effectiveness of integrated care has not been confirmed by limited evidence. Few studies have adopted a systematic approach to designing and conducting comprehensive process evaluations guided by scientific frameworks.ConclusionIntegrated care improves frailty and functional ability in community‐dwelling frail older adults but lacks consistent benefits for other outcomes. The lack of evidence on cost‐effectiveness and the caregiver and professional outcomes highlight critical gaps in current research. The absence of systematic process evaluations underscores the need for future studies to adopt rigorous frameworks to assess them.ImpactThis implicates that more research, particularly in underserved regions that lack a high standard of usual medical services, should emphasise the outcomes of caregivers and healthcare professionals, process evaluation, and health economics. Policymakers and practitioners must consider these gaps when implementing integrated care programmes to ensure equitable and sustainable healthcare solutions.Reporting MethodPRISMA 2020 Checklist.Patient or Public ContributionNo patient or public contribution.PROSPERO Registration NumberCRD42024568811
期刊介绍:
The Journal of Advanced Nursing (JAN) contributes to the advancement of evidence-based nursing, midwifery and healthcare by disseminating high quality research and scholarship of contemporary relevance and with potential to advance knowledge for practice, education, management or policy.
All JAN papers are required to have a sound scientific, evidential, theoretical or philosophical base and to be critical, questioning and scholarly in approach. As an international journal, JAN promotes diversity of research and scholarship in terms of culture, paradigm and healthcare context. For JAN’s worldwide readership, authors are expected to make clear the wider international relevance of their work and to demonstrate sensitivity to cultural considerations and differences.