The health care needs of multidimensional frail elderly patients with multimorbidity in non-inpatient settings: a qualitative study

Abstract

Purpose Our study aimed to explore the health care needs of older adults with multimorbidity assessed as multidimensionally frail from their perspective in Beijing, China, in a predominantly ambulatory setting. Methods This study was conducted using a qualitative approach involving semi-structured interviews of 21 at the Outpatient clinics, in four primary health care institutions (PHCIs), Beijing, China. The subjects were drawn from a cross-sectional survey that assessed frailty in older adults with multimorbidity. The Participants meeting the criteria were selected through purposive sampling until subject saturation. The interviews were transcribed and organized verbatim and then subjected to thematic analysis using inductive approach. Results A total of four themes on the needs of the multidimensional frail elderly patients with multimorbidity were identified, including enhancing self-management ability, reconstructing family intergenerational support, obtaining high-quality primary healthcare services, and improving the community home-based care service system. Conclusion This exploratory study is helpful to understand the healthcare needs of the frail elderly with multimorbidity from the perspectives of individuals, families, communities and society, in turn formulate healthcare promotion strategies. Appropriate policies and measures should be taken, such as assessing comprehensively the physiological, psychological and social functional status, determining priority interventions, improving family support functions, and formulating medical checklists for the frail elderly,as well as building a community- and home-based care service model that combines medical and nursing care.