Continuity of care for patients with chronic conditions from rural or remote Australia: A systematic review

Abstract

Objective: To identify the barriers and facilitators of achieving continuity of care between health services for patients with chronic conditions living in regional, rural and remote Australia.

Design: A systematic literature review of peer-reviewed journal publications between January 1990 and April 2018.

Setting: Publications were sourced from medical and scientific databases, including: PubMed; Embase; OvidSP; ProQuest research library; and ScienceDirect.

Participants: Studies, involving two groups, were included in the review: (a) Australian adults, residing in non-metropolitan areas with a chronic condition, who accessed health care services; and (b) health care service providers (eg, doctors) who provided care to non-metropolitan patients.

Main outcome measures: Facilitators and barriers of continuity of care for non-metropolitan patients with a chronic condition.

Results: Initially, 536 studies were included in the review. Of these, 12 studies were found to have met the eligibility criteria and were included in the final analysis.

Conclusions: Coordination of health care services for non-metropolitan patients with chronic conditions substantially improves the outcomes for patients. Overall, communication, availability of resources and location are the major barriers and facilitators to continuity of care, depending on how they are managed. Recommendations have been provided to assist practitioners and policy-makers to improve the experience of shared care and health outcomes for non-metropolitan patients.

Keywords: barriers; coordination of care; facilitators; quality of care; regional.