Title : Implementation pathway and protocol of integrated care for older people (ICOPE) in China: From global framework to local practice
Abstract:
Background: China faces an unprecedented aging challenge with fragmented care delivery and lack of standardized geriatric assessment protocols. While WHO launched the Integrated Care for Older People (ICOPE) framework in 2017, its adaptation to China's hospital-based healthcare systemremained unexplored.
Objective: To establish the first standardized clinical implementation pathway of WHO-ICOPE in China, creating a replicable "Hospital-Community-Home" closed-loop model suitable for resource-diverse settings.
Methods: We conducted a multi-center implementation study across 13 hospitals (2023–2027) involving1519 older adults. Key innovations included: (1) Localization: Transforming WHO's community-centric guidelines into a hospital-initiated "30-minute Fast-CGA" pathway usingrule-engine algorithms; (2) *Digitalization*: Developing an AI-powered decision support systemin personalized intervention recommendations; (3) Standardization: Establishingblockchain-based quality control. (4) Capacity Building: Training 900 certified ICOPE practitioners through a "1+N" multidisciplinary team model.
Results: The pilot will demonstrated significant clinical outcomes: 30-day readmission rates reduced, healthcare costs decreased, sarcopenia incidence dropped and intrinsic capacity scores improvedwithin 3 months. The project has generated 4 SCI publications, contributed to 3 national/groupstandards, and was designated as China's only national standardization pilot project for geriatric integrated care in 2025.
Conclusion: This study presents the first evidence-based implementation science model translatingWHO-ICOPE from theory to clinical practice in a middle-income country. The "LianyungangProtocol" offers a scalable template for addressing care fragmentation through digital health andstandardized pathways, contributing to the UN Decade of Healthy Ageing goals.
