TY - JOUR
AU - J. Yu
AU - H. Si
AU - W. Zhou
AU - Y. Yang
AU - Y. Li
AU - X. Wang
AU - H. Chen
AU - C. Wang
A1 - 
AB - AIMS: To assess the effectiveness, process, and economic outcomes of integrated care for community-dwelling frail older adults. DESIGN: A systematic review and meta-analysis. DATA SOURCES: We 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 METHODS: Randomised 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. RESULTS: This 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. CONCLUSION: Integrated 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. IMPACT: This 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 METHOD: PRISMA 2020 Checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. PROSPERO REGISTRATION NUMBER: CRD42024568811.
AD - School of Nursing, Peking University, Beijing, China.
AN - 41074465
BT - J Adv Nurs
C5 - Healthcare Disparities
DA - Oct 10
DO - 10.1111/jan.70275
DP - NLM
ET - 20251010
JF - J Adv Nurs
LA - eng
N2 - AIMS: To assess the effectiveness, process, and economic outcomes of integrated care for community-dwelling frail older adults. DESIGN: A systematic review and meta-analysis. DATA SOURCES: We 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 METHODS: Randomised 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. RESULTS: This 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. CONCLUSION: Integrated 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. IMPACT: This 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 METHOD: PRISMA 2020 Checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. PROSPERO REGISTRATION NUMBER: CRD42024568811.
PY - 2025
SN - 0309-2402
ST - Effectiveness, Process, and Economic Outcomes of Integrated Care for Community-Dwelling Frail Older Adults: A Systematic Review and Meta-Analysis
T1 - Effectiveness, Process, and Economic Outcomes of Integrated Care for Community-Dwelling Frail Older Adults: A Systematic Review and Meta-Analysis
T2 - J Adv Nurs
TI - Effectiveness, Process, and Economic Outcomes of Integrated Care for Community-Dwelling Frail Older Adults: A Systematic Review and Meta-Analysis
U1 - Healthcare Disparities
U3 - 10.1111/jan.70275
VO - 0309-2402
Y1 - 2025
ER -