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Risks and older adults with atrial fibrillation in rural communities: an integration lens

Kathy L Rush (School of Nursing, University of British Columbia Okanagan, Kelowna, Canada)
Nelly D Oelke (School of Nursing, University of British Columbia Okanagan, Kelowna, Canada)
R. Colin Reid (School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, Canada)
Carol Laberge (School of Nursing, University of British Columbia Okanagan, Kelowna, Canada)
Frank Halperin (Department of Medicine, University of British Columbia, Kelowna, Canada and Cardiology Associates, Kelowna, Canada)
Mary Kjorven (Department of Medicine, University of British Columbia Okanagan, Kelowna, Canada)

Journal of Integrated Care

ISSN: 1476-9018

Article publication date: 15 August 2016

164

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

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