TY - JOUR
AU - M. Hamiduzzaman
AU - V. McLennan
AU - H. Gaffney
AU - S. Miles
AU - S. Crook
AU - L. Grove
AU - M. Gray
AU - V. Flood
A1 - 
AB - Our review examines the operational dynamics and effectiveness of integrated healthcare models in Australia, focusing on their relevance for older rural adults with preventable chronic diseases. Using Whittemore and Knafl's (2005) systematic integrative review methods, we conducted a search across five databases, including Medline-EBSCO, PubMed, CINAHL, EMBASE, and SCOPUS. The Sustainable Integrated Chronic Care Models for Multimorbidity (SELFIE) framework, established by Leijten et al. (2018), was used for reflexive thematic synthesis. A two-stage screening process identified 15 integrated healthcare models, with five RCTs evaluating their effects on chronic conditions. The analysis revealed two key themes: aspects of care integration (service delivery, leadership, workforce, technology, and finance) and changes in patient and healthcare outcomes. Care coordination and multidisciplinary team care were common features, bridging gaps between health and social services for older patients. Despite challenges such as irregular funding and underutilisation of technology, several models demonstrated positive patient and healthcare outcomes. Virtual care platforms and remote monitoring systems have shown promise in improving patient engagement and enabling real-time care adjustments, particularly in rural areas with limited healthcare access. Our review highlights the need for integrated healthcare for older rural Australians with preventable chronic conditions, revealing the complexity of service models. Policy shifts towards coordinated services and changes in leadership and healthcare practices are essential to ensure this demographic receives integrated care that meets their needs.
AD - University Centre for Rural Health, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lismore, Australia. Electronic address: mohammad.hamiduzzaman@sydney.edu.au.; University Centre for Rural Health, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lismore, Australia. Electronic address: vanette.mclenna@sydney.edu.au.; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. Electronic address: Harry.Gaffney@health.nsw.gov.au.; University Centre for Rural Health, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lismore, Australia. Electronic address: sarah.e.miles@sydney.edu.au.; University Centre for Rural Health, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lismore, Australia. Electronic address: sarah.crook@sydney.edu.au.; University Centre for Rural Health, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lismore, Australia. Electronic address: lewis.grove@sydney.edu.au.; University Centre for Rural Health, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lismore, Australia. Electronic address: matthew.gray@sydney.edu.au.; University Centre for Rural Health, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lismore, Australia. Electronic address: vicki.flood@sydney.edu.au.
AN - 40157851
BT - Health Policy
C5 - Healthcare Disparities
DA - Oct
DO - 10.1016/j.healthpol.2025.105304
DP - NLM
ET - 20250322
JF - Health Policy
LA - eng
N2 - Our review examines the operational dynamics and effectiveness of integrated healthcare models in Australia, focusing on their relevance for older rural adults with preventable chronic diseases. Using Whittemore and Knafl's (2005) systematic integrative review methods, we conducted a search across five databases, including Medline-EBSCO, PubMed, CINAHL, EMBASE, and SCOPUS. The Sustainable Integrated Chronic Care Models for Multimorbidity (SELFIE) framework, established by Leijten et al. (2018), was used for reflexive thematic synthesis. A two-stage screening process identified 15 integrated healthcare models, with five RCTs evaluating their effects on chronic conditions. The analysis revealed two key themes: aspects of care integration (service delivery, leadership, workforce, technology, and finance) and changes in patient and healthcare outcomes. Care coordination and multidisciplinary team care were common features, bridging gaps between health and social services for older patients. Despite challenges such as irregular funding and underutilisation of technology, several models demonstrated positive patient and healthcare outcomes. Virtual care platforms and remote monitoring systems have shown promise in improving patient engagement and enabling real-time care adjustments, particularly in rural areas with limited healthcare access. Our review highlights the need for integrated healthcare for older rural Australians with preventable chronic conditions, revealing the complexity of service models. Policy shifts towards coordinated services and changes in leadership and healthcare practices are essential to ensure this demographic receives integrated care that meets their needs.
PY - 2025
SN - 0168-8510
SP - 105304
ST - Fostering integrated healthcare in rural Australia: A review of service models for older Australians with preventable chronic conditions
T1 - Fostering integrated healthcare in rural Australia: A review of service models for older Australians with preventable chronic conditions
T2 - Health Policy
TI - Fostering integrated healthcare in rural Australia: A review of service models for older Australians with preventable chronic conditions
U1 - Healthcare Disparities
U3 - 10.1016/j.healthpol.2025.105304
VL - 160
VO - 0168-8510
Y1 - 2025
ER -