Construction of an intelligent integrated care model for rural disabled older adults from the perspective of healthy aging: a concept mapping study

Medical, nursing, rehabilitation, long-term care, and social support resources for rural disabled older adults in China remain relatively fragmented, with insufficient coordination across institutions. This study aimed to construct an intelligent integrated care model for rural disabled older adults from the perspective of healthy aging and to provide a reference for integrating county-level care resources and coordinating service delivery. Following the structured process of concept mapping, diverse stakeholders from a county-level area in Henan Province, central China, were recruited to participate in focus-group brainstorming. They included healthcare professionals from county hospitals, township health centers, and village clinics, as well as rural disabled older adults and their caregivers. Stakeholder-generated ideas were integrated with evidence extracted from a scoping review and the guiding theoretical frameworks. After statement refinement, sorting, and rating, multidimensional scaling and hierarchical cluster analysis were performed to construct the concept map. Participants rated the importance and feasibility of each statement using separate 5-point Likert scales. A total of 80 stakeholders participated in nine focus-group interviews and generated 1,198 ideas. These were combined with 587 statements extracted from the scoping review and theoretical analysis, resulting in 1,785 initial statements. After duplicate removal, semantic consolidation, and refinement, 63 statements related to rural intelligent integrated care practices were retained. Thirty-eight multiple stakeholders grouped the statements to form 7 clusters. The 166 stakeholders, leaders and researchers evaluated the importance of statements in the range of 3 ~ 5 (4.62 ± 0.54, 95% CI [4.53,4.70]) and the feasibility score ranged from 2 ~ 5 (4.15 ± 0.70,95% CI [4.05,4.26]). Twelve stakeholder groups collectively categorized the practice approach statements into 9 distinct categories: financial support, service procedures/protocols, coordinated care, clinical integration, comprehensive geriatric assessment, Personalized Care Planning, interdisciplinary case conferences, case management, and information and communication technology support. Diverse stakeholders rated the intelligent integrated care model for rural disabled older adults as highly important and feasible. The model may provide a preliminary framework for coordinating multiple rural care resources, although its implementation effects require further evaluation through intervention studies.