Ensuring primary healthcare (PHC) accessibility to older people with multimorbidity is vital in preventing unnecessary health deterioration. However, older people ≥50 y of age in low- and middle-income countries (LMICs) face challenges in effectively accessing and utilizing PHC. A systematic review was conducted adopting the Andersen–Newman theoretical framework for health services utilization to assess evidence on factors that affect access to PHC by older people. This framework predicts that a series of factors (predisposing, enabling and need factors) influence the utilization of health services by people in general. Seven publications were identified and a narrative analytical method revealed limited research in this area. Facilitating factors included family support, closeness to the PHC facility, friendly service providers and improved functional status of the older people. Barriers included long distance and disjointed PHC services, fewer health professionals and a lack of person-centred care. The following needs were identified: increasing the number of health professionals, provision of PHC services under one roof and regular screening services. There is a need for more investment in infrastructure development, coordination of service delivery and capacity building of service providers in LMICs to improve access and utilization of PHC services for older people.

中文翻译：

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低收入和中等收入国家为患有进行性多病的老年人提供初级医疗保健服务：系统评价

确保患有多种疾病的老年人能够获得初级医疗保健 (PHC) 对于防止不必要的健康恶化至关重要。然而，低收入和中等收入国家 (LMIC) ≥50 岁的老年人在有效获得和利用初级卫生保健方面面临挑战。采用安德森-纽曼卫生服务利用理论框架进行了系统评价，以评估影响老年人获得初级保健服务的因素的证据。该框架预测一系列因素（诱发因素、促成因素和需求因素）会影响一般人对卫生服务的利用。确定了七份出版物，叙述性分析方法显示该领域的研究有限。促进因素包括家庭支持、靠近初级保健机构、友好的服务提供者以及老年人功能状况的改善。障碍包括距离远且脱节的初级卫生保健服务、卫生专业人员较少以及缺乏以人为本的护理。确定了以下需求：增加卫生专业人员的数量、提供一站式初级卫生保健服务以及定期筛查服务。中低收入国家需要在基础设施发展、服务提供协调和服务提供者能力建设方面进行更多投资，以改善老年人获得和利用初级卫生保健服务的机会。