Risks and older adults with atrial fibrillation in rural communities: an integration lens
Abstract
Purpose
Older adults with atrial fibrillation (AF) have put growing demands on a poorly integrated healthcare system. This is of particular concern in rural communities with rapid population aging and few healthcare resources elevating risk of stroke and mortality. The purpose of this paper is to explore healthcare delivery risks for rural older adults with AF.
Design/methodology/approach
This qualitative study collected data from AF patients, healthcare providers and decision makers. Ten patients participated in six-month care journeys involving interviews, logs, photos, and chart reviews. In total, 13 different patients and ten healthcare providers participated in focus groups and two decision makers participated in interviews.
Findings
Three key health service risks emerged: lack of patient-focussed access and self-management; unplanned care coordination and follow-up across the continuum of care; and ineffective teamwork with variable perspectives among patients, providers, and decision makers.
Originality/value
This study extends the understanding of risks to the health system level. Results provide important information for further research aimed at interventions to improve health service delivery and policy change to mitigate risks for this population.
Keywords
Acknowledgements
The authors extend our gratitude to Lorretta Colter, Lauren Gardner, Patricia Huijbregts, Chloe Pedersen, Matt Shay, and Julianna Sookraj for their valuable assistance with this study. The authors are indebted to the older adult patients, health care providers, and decision makers whose participation made this study possible. The Canadian Institutes of Health Research (CIHR) provided financial support for this research (Health Services and Systems for an Aging Population) (Grant number – CHL 126209). CIHR played no role in any part of the research process, from study design to submission.
Citation
Rush, K.L., Oelke, N.D., Reid, R.C., Laberge, C., Halperin, F. and Kjorven, M. (2016), "Risks and older adults with atrial fibrillation in rural communities: an integration lens", Journal of Integrated Care, Vol. 24 No. 4, pp. 188-200. https://doi.org/10.1108/JICA-03-2016-0012
Publisher
:Emerald Group Publishing Limited
Copyright © 2016, Emerald Group Publishing Limited