JMIR Publications

ABSTRACT

Background:

The rising prevalence of chronic diseases among older adults in China highlights the need for a more robust and efficient healthcare system. The existing system, characterized by fragmentation and limited coordination, faces challenges in delivering comprehensive care for chronic diseases among community-dwelling older adults with multiple comorbidities. There is a pressing need for tailored and integrated care for chronic conditions that promotes resource sharing, enhances access to advanced facilities, offers expert guidance, and ensures safe and effective management.

Objective:

The objectives are to investigate the unmet healthcare needs of Chinese community-dwelling older adults, explore the acceptability of the PRISMA model, and examine their needs for integrated care by case managers. Additionally, the study seeks to develop a comprehensive questionnaire to assess general and specific expectations, analyze expectation levels, identify sociodemographic factors influencing these expectations, and ultimately formulate an evidence-based integrated care model tailored to optimize healthcare delivery for ageing population.

Methods:

An exploratory sequential mixed-methods approach, including three sequential phases, incorporates elements from the PRISMA integrated care model and considers specific expectations of community-dwelling older adults with multiple comorbidities. Phase I involves a qualitative study to gather in-depth evidence on healthcare needs and integrated care expectations. Phase II focuses on developing and validating a comprehensive questionnaire. Phase III comprises a quantitative survey conducted across three cities representing central, eastern, and western China. Data integration will follow a data-building approach, combining qualitative and quantitative findings in the final analysis to provide a comprehensive understanding and refine insights into expectations towards integrated care for community-dwelling older adults.

Results:

The data collection process for this study will begin in October 2025. The duration of the study is planned to be 24 months. Ethical approval has been obtained from the Institutional Ethics Committee.

Conclusions:

This study aims to address significant gaps in the current healthcare provision while improving the quality, accessibility, and efficiency of services. By exploring how integrated care can be facilitated through a centralized point of access managed by a case manager, it seeks to enhance community care. The findings have the potential to inform policy decisions, guide the implementation of integrated care delivery, and ultimately improve health outcomes and the quality of life for older adults in China. Clinical Trial: Protocol Registration: The study protocol has been registered on osf.io (Registration DOI: https://doi.org/10.17605/OSF.IO/825AH).