Designing Integrated Care for Older Adults Living with Complex and Chronic Health Needs: A Scoping Review



Many Ontario Health Teams, a new way of organizing health services in Ontario, have prioritized older persons living with complex health needs in their planning. Thus, the time is right for evidence-informed, practical guidance that describes how to action integrated systems of care for older adults.

This scoping review, developed by Provincial Geriatrics Leadership Ontario, examines the literature to highlight core design elements that can assist planners, policy makers, health leaders and clinicians in their health system design work. It is also relevant to older persons and family/friend caregivers who, with this information in hand, can contribute to design and evaluation of the services intended to support them.

Our report draws from the literature and leverages the considerable experience of the specialized geriatric services clinical community to establish 13 evidence-based design elements of integrated care. Along with prior work such as the provincial Senior Friendly Care Framework1, this report also highlights the work that still needs to be done. We trust the findings from our work will offer valuable advice pertinent to overcoming current barriers and informing health system design that can truly result in integrated care for older persons in Ontario.

Review a summary table of the thirteen design elements here. Download the full report below.