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Barriers to and facilitators of integrated care for community-dwelling frail older adults: A qualitative study
Jiaqi Yu1, Hejing Chen1, Yang Yang1
1School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China.
Objectives:
To identify the barriers to and facilitators of the implementation of integrated care for frail community-dwelling older adults by primary care teams in China.
Design:
Qualitative explorative study, using semi-structured interviews and traditional content analysis.
Methods:
This study was conducted from January 2024 to June 2025, recruited 28 deliverers of integrated care and 16 recipients through purposive sampling. Participants underwent individual in-depth interviews. The updated Consolidated Framework for Implementation Research and the Theoretical Domains Framework were applied to guide interviews, analysis and reporting of findings.
Results:
The findings highlighted 56 implementation determinants of the implementation of integrated care for frail individuals: 26 barriers, 28 facilitators and 2 mixed factors. Common barriers were insufficient healthcare human resources, the complexity of integrated care with multiple components, its low priority compared with specific disease treatment, and poor beliefs about capabilities.
Conclusions:
The implementation of integrated care is influenced by barriers and facilitators from multiple levels (organizational and individual) and multiple sources (implementers and recipients). The findings will inform policy makers and practitioners in similar settings of potential strategies to overcome barriers and enhance facilitators, promoting the implementation of integrated care and improving older adults' quality of life and reducing healthcare costs.
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