How to describe an ecosystem of person-centred integrated care in long-term care? A scoping review

Introduction Countries in the European Union are faced with the question of which effective and sustainable care environments can withstand the different challenges that long-term care (LTC) systems face considering demographic change. This is where the strategy of person-centred (PC) integrated care (IC) comes into play. The research question of our work aims to elaborate factors and attributes of PC-IC ecosystems in LTC. We wanted to stratify the elements and relationships of PC-IC ecosystems that can help EU policymakers and LTC stakeholders create PC-IC models. Methods In order to elaborate the factors and attributes of those ecosystems, we employed a scoping review [1] using a literature research according to PRISMA-ScR [2]. We conducted the scoping review by using a defined Population-Concept-Context scheme (PCC) to identify existing evidence defining these ecosystems. The literature research was carried out from May till August 2024 in six databases (Medline, Cinahl, Cochrane Library, Web of Science, Scopus, EconLit) focusing on published literature within the period from 2014 to present. Results 37 out of 1862 publications were included in the review. The results of the scoping review show that ecosystems for PC-IC long-term care can be represented in a variety of contextual factors. Key internal factors include the organisational and structural framework, the information and communication system and factors relating to the caregiver and care receiver perspectives. External factors include regulatory requirements for IC, healthcare and social care system, the technological infrastructure, societal aspects as well as labour regulations. Pivot analysis underlines the study situation in the EU countries is still below average compared to all OECD countries. Conclusion The analysis of the contextual factors emphasises the importance of regulatory frameworks that are aligned with applicable PC-IC models. The external contextual factors impact the effectiveness of internal factors which include, for example, collaboration as well as the digital and technical infrastructure. Based on these results a typology of IC in LTC is to be developed and set in an alignment to the LTC typology of OECD countries [3]. [1] Munn, Z., Peters, M, Stern, C., et al. (2018), Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach, 18:143, Medical Research Methodology. [2] Moher D, Liberati A, Tetzlaff J, et al., Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6(7):e1000097. doi:10.1371/journal.pmed.1000097 [published Online First: 21 July 2009]. [3] Ariaans, M., Linden, P., Wendt, C (2021), Worlds of long-term care: A typology of OECD countries. 125, 609-617, Health Policy.