Service Users' Views on the Restructuring Of Primary and Community Care Services For Older Adults: A Scoping Review.

Research on the design, delivery, and restructuring of primary and community care for urban- and rural-dwelling older adults rarely considers the perspectives of service users. This review examined research literature on the restructuring of primary and community care services for older adults, with an emphasis on the views of older adults as service users. Using the scoping review methodology, five databases were searched for research papers ranging from 2005 to 2019. Articles were screened by title, abstract, and full text; and citation tracing was performed. Research articles on the design, delivery, and restructuring of primary and community care services were included. Attention was paid to the views of older adults as service users. Both urban and rural perspectives were considered. Twenty-four articles met the inclusion criteria. At least two individuals read each article and extracted the data. Data were themed using an inductive approach. Four themes were identified: (1) fragmented service delivery, (2) service discrepancies between urban and rural geographies, (3) reliance on informal supports, and (4) tailoring restructuring to meet community needs. There are discrepancies in the provision of healthcare services between rural and urban areas as restructuring rarely considers the perspectives of ruraldwelling older adults as service users. In order for healthcare services to address inequities and enable rural older adults to age in place, policy makers need to seek and act upon the views of both urban- and rural-dwelling older adults. [ABSTRACT FROM AUTHOR]