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. 2024 Jan 23;24(1):123.
doi: 10.1186/s12913-023-10387-w.

Rehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models

Vanessa Seijas  1   2   3 , Roxanne Maritz  4   5 , Satish Mishra  6 , Renaldo M Bernard  7 , Patricia Fernandes  8 , Viola Lorenz  4 , Barbara Machado  4 , Ana María Posada  9 , Luz Helena Lugo-Agudelo  9 , Jerome Bickenbach  4   5   7 , Carla Sabariego  4   5   7
Affiliations

Rehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models

Vanessa Seijas et al. BMC Health Serv Res. .

Erratum in

Abstract

Background: The world population is ageing rapidly. Rehabilitation is one of the most effective health strategies for improving the health and functioning of older persons. An understanding of the current provision of rehabilitation services in primary care (PC) is needed to optimise access to rehabilitation for an ageing population. The objectives of this scoping review are a) to describe how rehabilitation services are currently offered in PC to older persons, and b) to explore age-related differences in the type of rehabilitation services provided.

Methods: We conducted a secondary analysis of a scoping review examining rehabilitation models for older persons, with a focus on PC. Medline and Embase (2015-2022) were searched to identify studies published in English on rehabilitation services for people aged 50 + . Two authors independently screened records and extracted data using the World Health Organization (WHO)'s operational framework, the Primary Health Care Systems (PRIMASYS) approach and the WHO paper on rehabilitation in PC. Data synthesis included quantitative and qualitative analysis.

Results: We synthesised data from 96 studies, 88.6% conducted in high-income countries (HICs), with 31,956 participants and identified five models for delivering rehabilitation to older persons in PC: community, home, telerehabilitation, outpatient and eldercare. Nurses, physiotherapists, and occupational therapists were the most common providers, with task-shifting reported in 15.6% of studies. The most common interventions were assessment of functioning, rehabilitation coordination, therapeutic exercise, psychological interventions, and self-management education. Environmental adaptations and assistive technology were rarely reported.

Conclusions: We described how rehabilitation services are currently provided in PC and explored age-related differences in the type of rehabilitation services received. PC can play a key role in assessing functioning and coordinating the rehabilitation process and is also well-placed to deliver rehabilitation interventions. By understanding models of rehabilitation service delivery in PC, stakeholders can work towards developing more comprehensive and accessible services that meet the diverse needs of an ageing population. Our findings, which highlight the role of rehabilitation in healthy ageing, are a valuable resource for informing policy, practice and future research in the context of the United Nations Decade of Healthy Ageing, the Rehab2030 initiative and the recently adopted WHA resolution on strengthening rehabilitation in health systems, but the conclusions can only be applied to HICs and more studies are needed that reflect the reality in low- and middle-income countries.

Keywords: And health policy; Health services delivery; Healthy ageing; Older persons; Primary health care; Rehabilitation.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) [39]. Search of May 31, 2022. *Excluded by random sampling of 65%
Fig. 2
Fig. 2
Frequency of rehabilitation interventions by categories and models of rehabilitation service delivery
Fig. 2
Fig. 2
Frequency of rehabilitation interventions by categories and models of rehabilitation service delivery
Fig. 2
Fig. 2
Frequency of rehabilitation interventions by categories and models of rehabilitation service delivery
See this image and copyright information in PMC

References

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