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. 2022 Jul 25;19(15):9063.
doi: 10.3390/ijerph19159063.

Frail Older People Ageing in Place in Italy: Use of Health Services and Relationship with General Practitioner

Maria Gabriella Melchiorre  1 , Marco Socci  1 , Sabrina Quattrini  1 , Giovanni Lamura  1 , Barbara D'Amen  1
Affiliations

Frail Older People Ageing in Place in Italy: Use of Health Services and Relationship with General Practitioner

Maria Gabriella Melchiorre et al. Int J Environ Res Public Health. .

Abstract

Functional limitations, chronic diseases and frailty often occur in later life. These aspects become very challenging when older people age alone in place, thus needing support in the activities of daily living, and in this context, it is important they can access and use health services. The present study aimed to explore these issues in Italy. In 2019, 120 qualitative interviews were carried out within the "Inclusive Ageing in Place" (IN-AGE) project, involving frail older people living at home in three Italian regions (Lombardy, Marche, and Calabria). A content analysis and some quantifications of main statements are presented. Results showed that the majority of seniors report poor self-rated health (SRH), suffer from many chronic diseases, and mainly use the General Practitioner (GP) and Medical Specialists (MSs), even though long waiting list in the public sector and high costs in the private one act as barriers to access health services. Complaints regarding GPs mainly refer to the almost exclusive provision of prescriptions and the lack of home visits. Some regional peculiarities highlighted a better overall context in the north than in the south, especially with regards to the public health sector. These results can provide useful insights for policy makers, in order to deliver health services assuring frail, older people the continuity of assistance needed at home.

Keywords: General Practitioner; Italy; ageing in place; barriers to use; frail older people; health services access; living alone; self-rated health.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Main diseases (n). Some respondents reported more than one category of main disease.
Figure 2
Figure 2
Public health services used by older people, by regions (n, GP excluded). Some respondents reported more than one type of listed public health services. MS was mainly cardiologist, physiatrist, orthopedist and diabetologist. Diagnostic tests were mainly blood/urine tests, ultrasound, electrocardiogram (ECG), and computed axial tomography (TAC). Also, nurses at home for injections, withdrawals and catheter management.
Figure 3
Figure 3
Private health services used by older people, by regions (n). Some respondents reported more than one type of listed private health services. MS was mainly cardiologist, physiatrist, orthopedist and diabetologist. Also, nurses at home for injections and withdrawals. Diagnostic tests were mainly blood/urine tests, ultrasound and electrocardiogram (ECG).
Figure 4
Figure 4
Barriers for using public health services, by region (n). Some respondents reported more than one type of listed barriers.
Figure 5
Figure 5
Barriers for using private health services, by region (n). Some respondents reported more than one type of listed barriers.
Figure 6
Figure 6
Relationship with GP (n).
Figure 7
Figure 7
Reasons supporting a bad relationship with GP (n). Some respondents reported more than one type of listed reasons.
Figure 8
Figure 8
Reasons supporting a good relationship with GP (n). No reason was reported in three cases.
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