Review Article

A systematic review and qualitative analysis of geriatric models of care for rural and remote populations

AUTHORS

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Katherine E Krause1
MSc, MD, Geriatrician

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Kristina Marie Kokorelias2
PhD, Senior Academic Program Coordinator

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Samir K Sinha3
MD, DPhil, Professor of Medicine *

AFFILIATIONS

1 Division of Geriatric Medicine, Peterborough Regional Health Centre, 1 Hospital Drive, Peterborough, ON K9J 7C6, Canada

2 Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, 475-600 University Avenue, Toronto, ON M5G 1X5, Canada

3 Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, 475-600 University Avenue, Toronto, ON M5G 1X5, Canada; Division of Geriatric Medicine, Department of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Cir, Toronto, ON M5S 1A8, Canada; and Institute of Health Policy, Management and Evaluation, University of Toronto, 425-155 College St, Toronto, ON M5T 1P8, Canada

ACCEPTED: 17 June 2022


early abstract:

Purpose: Much is known about the healthcare needs of rural and remote communities, however, understanding how to best deliver geriatric models of care in these settings has received less attention. The purpose of this systematic review was to identify necessary key components of existing models of geriatric care serving rural or remote populations.
Methods: A systematic literature review was conducted using MEDLINE, CINAHL, and EMBASE databases to identify articles that described models of geriatric care serving rural or remote populations.  A qualitative case study and key component analysis approach was used to identify necessary model components.
Findings: Eight articles were included. We identified 8 distinct components that may improve the successful delivery of models of geriatric care serving rural or remote populations. Environmental assessments were done in 6/8 models. Model integration with the local healthcare system, local provider leadership, and local provider education in geriatrics were present in 5/8 models. Furthermore, 3/8 models used high-risk screening principles and included geriatrician consultation. One (1/8) model described active community engagement, and 1/8 used telemedicine.
Conclusions: Future geriatric care delivery models designed to serve rural or remote populations are encouraged to use an evidence-based framework based on 8 distinct model characteristics found in the literature that aim to support the ideal provision of effective and accessible geriatric medical care.