Patient journey: implications for improving and integrating care for older adults with chronic obstructive pulmonary disease.

Many patients, particularly older patients, interact with multiple providers while accessing health care services in a variety of different settings over extended periods of time. Understanding older patients' experiences of their journeys through the health system is critical to improving service integration and quality of care. In this study, we have summarized the experiences of four patients living with chronic obstructive pulmonary disease as they interacted with the health care system over a three-month period following hospital discharge. Guided by case study methodology, we gathered data through semi-structured interviews and patient logs. Three overarching themes - social support, system navigation, and access - emerged from the data. Attending to provider-patient and provider-provider communication, and to patient social support and self-care needs, could improve integration and care outcomes. Achieving what patients perceive as an integrated and effective system will require time and commitment.