Rehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models
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...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-023-10387-w |
| _version_ | 1827328131295346688 |
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| author | Vanessa Seijas Roxanne Maritz Satish Mishra Renaldo M Bernard Patricia Fernandes Viola Lorenz Barbara Machado Ana María Posada Luz Helena Lugo-Agudelo Jerome Bickenbach Carla Sabariego |
| author_facet | Vanessa Seijas Roxanne Maritz Satish Mishra Renaldo M Bernard Patricia Fernandes Viola Lorenz Barbara Machado Ana María Posada Luz Helena Lugo-Agudelo Jerome Bickenbach Carla Sabariego |
| author_sort | Vanessa Seijas |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-07T15:12:31Z |
| format | Article |
| id | doaj.art-d84b7890ff804d289b7c98dfc7a46516 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-03-07T15:12:31Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-d84b7890ff804d289b7c98dfc7a465162024-03-05T18:06:09ZengBMCBMC Health Services Research1472-69632024-01-0124112010.1186/s12913-023-10387-wRehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery modelsVanessa Seijas0Roxanne Maritz1Satish Mishra2Renaldo M Bernard3Patricia Fernandes4Viola Lorenz5Barbara Machado6Ana María Posada7Luz Helena Lugo-Agudelo8Jerome Bickenbach9Carla Sabariego10Faculty of Health Sciences and Medicine, University of LucerneFaculty of Health Sciences and Medicine, University of LucerneDisability, Rehabilitation, Palliative and Long-Term Care, Health Workforce and Service Delivery Unit, Division of Country Health Policies and Systems, WHO Regional Office for EuropeAgeing, Functioning Epidemiology and Implementation, Swiss Paraplegic ResearchDepartment of Clinical Medicine, Federal University of ParanaFaculty of Health Sciences and Medicine, University of LucerneFaculty of Health Sciences and Medicine, University of LucerneRehabilitation in Health Research Group, Sede de Investigación Universitaria, University of AntioquiaRehabilitation in Health Research Group, Sede de Investigación Universitaria, University of AntioquiaFaculty of Health Sciences and Medicine, University of LucerneFaculty of Health Sciences and Medicine, University of LucerneAbstract 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.https://doi.org/10.1186/s12913-023-10387-wHealthy ageingOlder personsPrimary health careRehabilitationHealth services deliveryAnd health policy |
| spellingShingle | Vanessa Seijas Roxanne Maritz Satish Mishra Renaldo M Bernard Patricia Fernandes Viola Lorenz Barbara Machado Ana María Posada Luz Helena Lugo-Agudelo Jerome Bickenbach Carla Sabariego Rehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models BMC Health Services Research Healthy ageing Older persons Primary health care Rehabilitation Health services delivery And health policy |
| title | Rehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models |
| title_full | Rehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models |
| title_fullStr | Rehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models |
| title_full_unstemmed | Rehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models |
| title_short | Rehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models |
| title_sort | rehabilitation in primary care for an ageing population a secondary analysis from a scoping review of rehabilitation delivery models |
| topic | Healthy ageing Older persons Primary health care Rehabilitation Health services delivery And health policy |
| url | https://doi.org/10.1186/s12913-023-10387-w |
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