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Fostering integrated healthcare in rural Australia: A review of service models for older Australians with preventable chronic conditions

Author

Listed:
  • Hamiduzzaman, Mohammad
  • McLennan, Vanette
  • Gaffney, Harry
  • Miles, Sarah
  • Crook, Sarah
  • Grove, Lewis
  • Gray, Matthew
  • Flood, Victoria

Abstract

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.

Suggested Citation

  • Hamiduzzaman, Mohammad & McLennan, Vanette & Gaffney, Harry & Miles, Sarah & Crook, Sarah & Grove, Lewis & Gray, Matthew & Flood, Victoria, 2025. "Fostering integrated healthcare in rural Australia: A review of service models for older Australians with preventable chronic conditions," Health Policy, Elsevier, vol. 160(C).
    • Handle: RePEc:eee:hepoli:v:160:y:2025:i:c:s0168851025000600
    DOI: 10.1016/j.healthpol.2025.105304
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    References listed on IDEAS

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    1. Leijten, Fenna R.M. & Struckmann, Verena & van Ginneken, Ewout & Czypionka, Thomas & Kraus, Markus & Reiss, Miriam & Tsiachristas, Apostolos & Boland, Melinde & de Bont, Antoinette & Bal, Roland & Bus, 2018. "The SELFIE framework for integrated care for multi-morbidity: Development and description," Health Policy, Elsevier, vol. 122(1), pages 12-22.
    2. Siqin Wang & Yan Liu & Jack Lam & Zhe Gao, 2021. "Chronic Illness, Subjective Wellbeing, and Health Services Availability: A Study of Older Adults in Australia," IJERPH, MDPI, vol. 18(15), pages 1-15, July.
    3. Matthew J Page & Joanne E McKenzie & Patrick M Bossuyt & Isabelle Boutron & Tammy C Hoffmann & Cynthia D Mulrow & Larissa Shamseer & Jennifer M Tetzlaff & Elie A Akl & Sue E Brennan & Roger Chou & Jul, 2021. "The PRISMA 2020 statement: An updated guideline for reporting systematic reviews," PLOS Medicine, Public Library of Science, vol. 18(3), pages 1-15, March.
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