Evaluation Items for Community-Based Health Care Focusing on Social Aspects: A Literature Review

The progressive aging of society has become a global concern, and is expected to lead to the development of effective, sustainable, person-centered, integrated community-based care systems. However, there is insufficient evidence regarding effective integrated community-based care. In particular, few studies have focused on social aspects of the community environment related to elderly health. This study aimed to consider social aspects as evaluation items, focusing particularly on social determinants from the perspective of community-dwelling people, to explore truly effective integrated community-based care to improve elderly health. The definition of social determinants means social cohesion in social and community contexts. A literature review of English articles published in peer-reviewed journals up to October 2019 was conducted using PubMed, MEDLINE, and CINAHL with the following search terms: “social cohesion,” “elderly health,” “mental health” and “community.” Identified articles were screened based on title and abstract, and selected articles were subjected to full-text assessment and critical review. All references cited in the selected articles were also reviewed. The following inclusion criteria were used: 1) studies targeting community-dwelling elderly people or community-dwelling people including elderly people as participants; 2) studies with clear descriptions of social factors in the Methods section; and 3) studies with clear descriptions of health-related items in the Methods section. From the 21 articles analyzed, of which 9 articles defined social determinants as social cohesion in social and community context, 37 items were extracted as social aspects at the community level that reflect the perspective of residents. These items can be developed as evaluation items for community-based health care outcomes through consensus among community health care providers and further investigation.