Challenges of the Integrated Health Plan for the Older People in Khuzestan Province, Iran

Besides the growing rate of elderlies who have lost a considerable part of their internal and normal capacity, as well as their complex long–term conditions, the rapid ageing of the population has created major challenges for health systems that have long been designed for providing health and therapeutic services. In the meantime, the presence of various organizations in providing the country's elderly services has resulted in the formation of repetitive and various services, confusion among the elderly, and noncompliance with all the requirements of older adults. Choosing and designing a suitable system to provide an integrated plan to ensure the provision of required services for older adults is necessary. Hence, this study aimed to explain older people's integrated health services plan based on the existing challenges and policies.

This study was performed within a qualitative approach framework and by a data–based research method. This study was conducted in two stages to achieve the study objectives. The first step addressed identifying the challenges in providing an integrated health plan for elderly services. The research tool included semi–structured interviews. Using a targeted sampling method, 12 experts, trustees, specialists in geriatrics, and 5 elderlies who used the integrated health services in Khuzestan Province, Iran, were interviewed. The interviews continued until reaching data saturation. Corbin and Strauss's method (2014) was employed to analyze the data. Data were analyzed in three stages: open, axial, and selective coding. The second stage of this research included specifying the optimal solutions to solve the present challenges and policies. For this stage, effective solutions were prepared to solve the identified challenges after determining the initial model of the study. The experts who were interviewed were provided with these solutions through a questionnaire. At this stage, the Delphi method was utilized to determine the optimal solutions to the identified challenges in the integrated health plan for older people. To ensure the study's validity and reliability, Lincoln and Guba's (1994) trustworthiness assessment criteria were used in the qualitative part using the criteria of credibility, transferability, reliability, and conformability.

The findings of this research show the challenges of developing an integrated health plan for elderly services in five main categories, including poor participation of older people, lack of human resources and laboratory facilities, healthcare providers' poor training and skills, provision of limited services, and low job motivation of healthcare providers. Also, 26 subcategories were identified. Finally, 29 solutions were determined to solve the challenges.

According to the present study's findings, despite the helpful services presented to the elderly community by the integrated health service plan, it has several major challenges. This study provided appropriate solutions by identifying these challenges that may pave the way for future planning and research on formulating the policies and plans for the merged elderly service plan.