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. 2018 Aug 7;19(1):137.
doi: 10.1186/s12875-018-0821-7.

Coordinating care for older adults in primary care settings: understanding the current context

Jacobi Elliott  1 , Paul Stolee  2 , Veronique Boscart  3 , Lora Giangregorio  2 , George Heckman  2
Affiliations

Coordinating care for older adults in primary care settings: understanding the current context

Jacobi Elliott et al. BMC Fam Pract. .

Abstract

Background: It is well known that older adults are high users of the health care system. Older adults with chronic conditions receive care from multiple providers, across multiple settings, and this care is often unorganized and confusing. In 2005, Ontario established a model of inter-professional primary care (family health teams) with the aim of providing enhanced interdisciplinary primary care to patients. Primary care requires an in-depth understanding of the operations of primary care teams and their relationships with other community services. The aim of this study was to develop a deeper understanding of the current operations of two family health teams in Ontario, including their current processes for referrals, information sharing, and engagement of patients in decision-making.

Methods: Focus group and individual semi-structured interviews with health care providers were conducted. Purposeful sampling was used to ensure information was obtained from different professional perspectives. Interviews were audio-recorded and transcribed verbatim. Using NVivo 10, data were analyzed using line by line thematic analysis techniques. A cluster technique was then applied to group similar codes into themes.

Results: Three focus group interviews (involving 4-6 health care providers/focus group) and six individual interviews were conducted with health care providers from two primary care teams and surrounding community care organizations. Six key themes were identified: 1) challenges engaging older adults in decisions about their care; 2) who is responsible for coordinating the care? 3) fragmented information sharing between health care providers; 4) lack of standardized referral processes and follow-up; 5) identifying services in the community for older adults; and 6) caring for older adults in rural communities.

Conclusions: The results of this study provide an in-depth understanding of the current context in which the primary care teams are currently operating. Improved primary care will require stronger processes of coordination, greater knowledge of and connections with other community services, and enhanced patient engagement processes. This information provides a helpful basis for implementing interventions in primary care.

Keywords: Care coordination; Health care providers; Older adults; Primary care; Qualitative methods.

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Conflict of interest statement

Ethics approval and consent to participate

Ethics clearance for this study was obtained from the University of Waterloo’s Office of Research Ethics (ORE #20452). Written consent for participation was obtained.

Consent for publication

The information participants received about the study included an explanation that results would be published. Thus, their written consent covered publication as well as participation.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. Starfield B, Shi L, Mackino J. Contribution of primary care to health systems and health. Milbank Q. 2005;8:457–502. doi: 10.1111/j.1468-0009.2005.00409.x. - DOI - PMC - PubMed
    1. Bodenheimer T. Coordinating care--a perilous journey through the health care system. N Engl J Med. 2008;358(10):1064. doi: 10.1056/NEJMhpr0706165. - DOI - PubMed
    1. Health Council of Canada. Primary health care: background paper. 2005. Retrieved on May 20, 2015 from https://healthcouncilcanada.ca/files/2.44-BkgrdPrimaryCareENG.pdf.
    1. Glasby J, Dickinson H, Peck E. Guest editorial: partnership working in health and social care. Health Soc Care Community. 2006;14(5):373–374. doi: 10.1111/j.1365-2524.2006.00656.x. - DOI - PubMed
    1. Banfield M, Gardner K, McRae I, Gillespie J, Wells R, Yen L. Unlocking information for coordination of care in Australia: a qualitative study of information continuity in four primary health care models. BMC Fam Pract. 2013;14(34). 10.1186/1471-2296-14-34. - PMC - PubMed

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