OP75 Experiences of Hospital Care for Multiple Long-Term Conditions: a Scoping Review of Qualitative Studies

Background The prevalence of multiple long-term conditions (MLTC) – the co-existence of two or more chronic health conditions – is increasing, with far-reaching consequences for individuals and healthcare systems. People living with MLTC are more likely than those without to experience poor quality of life and reduced healthy life expectancy. They are also at risk of being disadvantaged by care systems configured to provide specialist treatment for single conditions. Understanding experiences of hospital care is a vital step in constructing a knowledge base to facilitate health systems to meet the challenge of delivering care for MLTC. The aim of this scoping review was to identify and summarise published qualitative studies that explored experiences of hospital care for MLTC. Methods In line with PRISMA guidance for scoping reviews, a systematic search strategy was developed to identify primary qualitative research exploring experiences of hospital care for MLTC from the perspective of people receiving treatment, their informal caregivers and healthcare professionals published between 2010 and 2022. We conducted electronic searches of MEDLINE, CINAHL, PsycInfo, Proquest Social Science Premium, Web of Science, Scopus and Embase, supplemented by citation tracking. Studies were selected for inclusion following an independent screening process. Results Of 8002 titles and abstracts screened, 54 papers reporting findings from 42 studies conducted in 14 countries were identified for inclusion in the review. The perspectives of people living with multiple long-term conditions (n=29), relatives (n=18) and healthcare professionals (n=33) were represented, with 18 papers reporting experiences of multiple groups. Findings across countries were remarkably similar, with study participants highlighting a range of influences on their experiences, including limited service integration, lack of coordinated care, insufficient time to attend to the needs of people with MLTC, and limited confidence amongst healthcare professionals to treat conditions outside of their clinical specialty. Few studies explored inequities in experiences of hospital care. Conclusion Existing qualitative research on the experiences of hospital care for people living with MLTC illuminates the tension between the desire to achieve person-centred, holistic care and the pressures inherent within a system focussed on increasing specialisation, reduced inpatient provision and accelerated care pathways. The review’s findings point towards a need for integrated models of care better able to respond to the needs of people living with MLTC. Future research could pay more attention to social and health inequalities that may shape the ways in which people with MLTC access and engage with hospital care.