{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:15:06Z","timestamp":1791807306775,"version":"4.3.4"},"reference-count":97,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T00:00:00Z","timestamp":1658707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002803","name":"Fondazione Cariplo","doi-asserted-by":"publisher","award":["2017-0941"],"award-info":[{"award-number":["2017-0941"]}],"id":[{"id":"10.13039\/501100002803","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Italian Ministry of Health to IRCCS INRCA","award":["2017-0941"],"award-info":[{"award-number":["2017-0941"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Functional limitations, chronic diseases and frailty often occur in later life. These aspects become very challenging when older people age alone in place, thus needing support in the activities of daily living, and in this context, it is important they can access and use health services. The present study aimed to explore these issues in Italy. In 2019, 120 qualitative interviews were carried out within the \u201cInclusive Ageing in Place\u201d (IN-AGE) project, involving frail older people living at home in three Italian regions (Lombardy, Marche, and Calabria). A content analysis and some quantifications of main statements are presented. Results showed that the majority of seniors report poor self-rated health (SRH), suffer from many chronic diseases, and mainly use the General Practitioner (GP) and Medical Specialists (MSs), even though long waiting list in the public sector and high costs in the private one act as barriers to access health services. Complaints regarding GPs mainly refer to the almost exclusive provision of prescriptions and the lack of home visits. Some regional peculiarities highlighted a better overall context in the north than in the south, especially with regards to the public health sector. These results can provide useful insights for policy makers, in order to deliver health services assuring frail, older people the continuity of assistance needed at home.<\/jats:p>","DOI":"10.3390\/ijerph19159063","type":"journal-article","created":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T21:20:59Z","timestamp":1658784059000},"page":"9063","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Frail Older People Ageing in Place in Italy: Use of Health Services and Relationship with General Practitioner"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4428-3749","authenticated-orcid":false,"given":"Maria","family":"Melchiorre","sequence":"first","affiliation":[{"name":"Centre for Socio-Economic Research on Ageing, IRCCS INRCA-National Institute of Health and Science on Ageing, 60124 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9093-2167","authenticated-orcid":false,"given":"Marco","family":"Socci","sequence":"additional","affiliation":[{"name":"Centre for Socio-Economic Research on Ageing, IRCCS INRCA-National Institute of Health and Science on Ageing, 60124 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5670-2034","authenticated-orcid":false,"given":"Sabrina","family":"Quattrini","sequence":"additional","affiliation":[{"name":"Centre for Socio-Economic Research on Ageing, IRCCS INRCA-National Institute of Health and Science on Ageing, 60124 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9278-9544","authenticated-orcid":false,"given":"Giovanni","family":"Lamura","sequence":"additional","affiliation":[{"name":"Centre for Socio-Economic Research on Ageing, IRCCS INRCA-National Institute of Health and Science on Ageing, 60124 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8986-5216","authenticated-orcid":false,"given":"Barbara","family":"D\u2019Amen","sequence":"additional","affiliation":[{"name":"Centre for Socio-Economic Research on Ageing, IRCCS INRCA-National Institute of Health and Science on Ageing, 60124 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,25]]},"reference":[{"key":"ref_1","unstructured":"ISTAT (2022). Popolazione Italiana Residente al 1\u00b0 Gennaio, 2022, ISTAT. Available online: http:\/\/demo.istat.it\/popres\/index.php?anno=2021&lingua=ita."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2193","DOI":"10.1016\/S0140-6736(21)01733-5","article-title":"The evolution of the Italian National Health Service","volume":"398","author":"Ricciardi","year":"2021","journal-title":"Lancet"},{"key":"ref_3","unstructured":"EUROSTAT (2022). Population Structure and Ageing, Statistics Explained: European Commission. Available online: https:\/\/ec.europa.eu\/eurostat\/statistics-explained\/index.php?title=Population_structure_and_ageing."},{"key":"ref_4","unstructured":"ISTAT (2021). Famiglie, Persone Sole, ISTAT. Available online: http:\/\/dati.istat.it\/Index.aspx?QueryId=17631."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Melchiorre, M.G., Quattrini, S., Lamura, G., and Socci, M. (2022). Role and Characteristics of Personal Care Assistants of Frail Older People with Functional Limitations Ageing in Place in Italy. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19073969"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Mitnitski, A.B., Graham, J.E., Mogilner, A.J., and Rockwood, K. (2002). Frailty, fitness and late-life mortality in relation to chronological and biological age. BMC Geriatr., 2.","DOI":"10.1186\/1471-2318-2-1"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"564","DOI":"10.3389\/fpsyg.2020.00564","article-title":"Multidimensional Approach to Frailty","volume":"11","author":"Wleklik","year":"2020","journal-title":"Front. Psychol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"101047","DOI":"10.1016\/j.arr.2020.101047","article-title":"A multidimensional approach to frailty in older people","volume":"60","author":"Pilotto","year":"2020","journal-title":"Ageing Res. Rev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1016\/j.cjca.2016.05.011","article-title":"Assessment and utility of frailty measures in critical illness, cardiology, and cardiac surgery","volume":"32","author":"Rajabali","year":"2016","journal-title":"Can. J. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Vermeulen, J., Neyens, J.C., Van Rossum, E., Spreeuwenberg, M.D., and De Witte, L.P. (2011). Predicting ADL disability in community dwelling elderly people using physical frailty indicators: A systematic review. BMC Geriatr., 11.","DOI":"10.1186\/1471-2318-11-33"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"J\u0119drzejczyk, M., Fory\u015b, W., Czapla, M., and Uchmanowicz, I. (2022). Relationship between Multimorbidity and Disability in Elderly Patients with Coexisting Frailty Syndrome. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19063461"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1089\/pop.2018.0069","article-title":"Recent Patterns of Multimorbidity among Older Adults in High-Income Countries","volume":"22","author":"Chin","year":"2019","journal-title":"Popul. Health Manag."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1093\/ageing\/afx150","article-title":"New horizons in multimorbidity in older adults","volume":"46","author":"Yarnall","year":"2017","journal-title":"Age Ageing"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Molist-Brunet, N., Sevilla-S\u00e1nchez, D., Puigoriol-Juvanteny, E., Bajo-Pe\u00f1as, L., Cantizano-Baldo, I., Cabanas-Collell, L., and Espaulella-Panicot, J. (2022). Individualized Medication Review in Older People with Multimorbidity: A Comparative Analysis between Patients Living at Home and in a Nursing Home. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19063423"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Stafford, G., Vill\u00e9n, N., Roso-Llorach, A., Troncoso-Mari\u00f1o, A., Monteagudo, M., and Viol\u00e1n, C. (2021). Combined Multimorbidity and Polypharmacy Patterns in the Elderly: A Cross-Sectional Study in Primary Health Care. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18179216"},{"key":"ref_16","unstructured":"Rodr\u00edguez-Laso, A., Caballero Mora, M.A., Garc\u00eda S\u00e1nchez, I., Alonso Bouz\u00f3n, C., Rodr\u00edguez Ma\u00f1as, L., Bernabei, R., Gabrovec, B., Hendry, A., Liew, A., and O\u2019Caoimh, R. (2019). Updated State of the Art Report on the Prevention and Management of Frailty, European Union. Available online: https:\/\/www.advantageja.eu\/images\/SoAR-AdvantageJA_Fulltext.pdf."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1038\/nature01135","article-title":"Stochastic and genetic factors influence tissue-specific decline in ageing C. Elegans","volume":"419","author":"Herndon","year":"2002","journal-title":"Nature"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Pasanen, T.P., Tamminen, N., Martelin, T., Mankinen, K., and Solin, P. (2021). Profiles of subjective health among people living alone: A latent class analysis. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-11396-2"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Li, C.M., Lin, C.H., Li, C.I., Liu, C.S., Lin, W.Y., Li, T.C., and Lin, C.C. (2021). Frailty status changes are associated with healthcare utilization and subsequent mortality in the elderly population. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-10688-x"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1016\/S0140-6736(14)61461-6","article-title":"Towards a comprehensive public health response to population ageing","volume":"385","author":"Beard","year":"2015","journal-title":"Lancet"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Chimento-D\u00edaz, S., S\u00e1nchez-Garc\u00eda, P., Franco-Antonio, C., Santano-Mogena, E., Espino-Tato, I., and Cordovilla-Guardia, S. (2022). Factors Associated with the Acceptance of New Technologies for Ageing in Place by People over 64 Years of Age. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19052947"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1093\/eurpub\/ckr133","article-title":"Health-care and home-care utilization among frail elderly persons in Belgium","volume":"22","author":"Hoeck","year":"2012","journal-title":"Eur. J. Public Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1093\/ageing\/afx157","article-title":"Frailty and healthcare costs-longitudinal results of a prospective cohort study","volume":"47","author":"Hajek","year":"2018","journal-title":"Age Ageing"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.jpsychores.2015.09.015","article-title":"Predictive validity of a frailty measure (GFI) and a case complexity measure (IM-E-SA) on healthcare costs in an elderly population","volume":"79","author":"Peters","year":"2015","journal-title":"J. Psychosom. Res."},{"key":"ref_25","unstructured":"Italian Ministry of Health (2020). Invecchiamento Della Popolazione e Sostenibilit\u00e0 del SSN, Consiglio Superiore di Sanit\u00e0. Available online: http:\/\/www.quadernidellasalute.it\/imgs\/C_17_pubblicazioni_3094_allegato.pdf."},{"key":"ref_26","unstructured":"ISTAT (2021). Le Condizioni di Salute Della Popolazione Anziana in Italia, Anno 2019, ISTAT. Available online: https:\/\/www.istat.it\/it\/files\/2021\/07\/Report-anziani-2019.pdf."},{"key":"ref_27","unstructured":"ISTAT (2019). Annuario Statistico Italiano, ISTAT. Available online: https:\/\/www.istat.it\/it\/files\/2019\/12\/Asi-2019.pdf."},{"key":"ref_28","unstructured":"ISTAT (2017). Anziani: Le Condizioni di Salute in Italia e Nell\u2019unione Europea. Anno 2015, ISTAT. Available online: https:\/\/www.istat.it\/it\/files\/2017\/09\/Condizioni_Salute_anziani_anno_2015.pdf."},{"key":"ref_29","unstructured":"ISTAT (2017). Condizioni di Salute e Ricorso ai Servizi Sanitari in Italia e Nell\u2019unione Europea. Indagine EHIS 2015, ISTAT. Available online: https:\/\/www.istat.it\/it\/archivio\/204655."},{"key":"ref_30","unstructured":"ISTAT (2021). Condizioni di Salute e Ricorso ai Servizi Sanitari in Italia e Nell\u2019unione Europea. Indagine EHIS 2019, ISTAT. Available online: https:\/\/www.istat.it\/it\/archivio\/265399."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"De Rossi, A. (2020). Aree Interne Tra Abbandoni e Riconquiste, Donzelli Editore.","DOI":"10.30682\/aa2004a"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"OECD (2020). OECD Regions and Cities at a Glance 2020, OECD Publishing. Available online: https:\/\/www.oecd.org\/publications\/oecd-regions-and-cities-at-a-glance-26173212.htm.","DOI":"10.1787\/959d5ba0-en"},{"key":"ref_33","unstructured":"NSIA\u2014National Strategy for Inner Areas (2021, September 20). Annual Report on the National Strategy for Inner Areas, Available online: https:\/\/www.agenziacoesione.gov.it\/wp-content\/uploads\/2020\/07\/Relazione_CIPE_2018.pdf."},{"key":"ref_34","unstructured":"ISTAT (2020). Le Misure Della Vulnerabilit\u00e0: Un\u2019applicazione a Diversi Ambiti Territoriali, ISTAT. Available online: https:\/\/www.istat.it\/it\/files\/\/2020\/12\/Le-misure-della-vulnerabilita.pdf."},{"key":"ref_35","unstructured":"Ritchie, J., and Lewis, J. (2003). Qualitative Research Practice. A Guide for Social Science Students and Researchers, Sage Publications."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Colombo, F., Llena-Nozal, A., Mercier, J., and Tjadens, F. (2011). Help Wanted? Providing and Paying for Long-Term Care, OECD Publishing. Available online: https:\/\/read.oecd-ilibrary.org\/social-issues-migration-health\/help-wanted_9789264097759-en#page5.","DOI":"10.1787\/9789264097759-en"},{"key":"ref_37","unstructured":"Lamura, G., Dohner, H., and Kofhal, C. (2008). Supporting Family Carers of Older People in Europe\u2014Empirical Evidence, Policy Trends and Future Perspectives, Lit Verlag."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1111\/j.1532-5415.1983.tb03391.x","article-title":"Assessing Self-Maintenance: Activities of Daily Living, Mobility, and Instrumental Activities of Daily Living","volume":"31","author":"Katz","year":"1983","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_39","unstructured":"ISTAT (2019). Conoscere il Mondo Della Disabilit\u00e0: Persone, Relazioni e Istituzioni, ISTAT. Available online: https:\/\/www.istat.it\/it\/files\/2019\/12\/Disabilit%C3%A0-1.pdf."},{"key":"ref_40","unstructured":"ISTAT (2011). Indagine Statistica Multiscopo Sulle Famiglie, ISTAT. Available online: https:\/\/www.istat.it\/it\/files\/\/2011\/01\/Arancio_Mod_IMF_8A.pdf."},{"key":"ref_41","unstructured":"European Union (2016). Regulation 2016\/679 of the European parliament and of the Council. General data protection regulation. Off. J. Eur. Union., 679, L 119\/1. Available online: https:\/\/eur-lex.europa.eu\/eli\/reg\/2016\/679\/oj."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Melchiorre, M.G., Quattrini, S., Lamura, G., and Socci, M. (2021). A Mixed-Methods Analysis of Care Arrangements of Older People with Limited Physical Abilities Living Alone in Italy. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182412996"},{"key":"ref_43","first-page":"72","article-title":"Framework Analysis: A Qualitative Methodology for Applied Policy Research","volume":"4","author":"Srivastava","year":"2009","journal-title":"J. Adm. Gov."},{"key":"ref_44","unstructured":"Bryman, A., and Burgess, R.G. (1994). Analyzing Qualitative Data, Routledge."},{"key":"ref_45","first-page":"20","article-title":"Qualitative Content Analysis","volume":"1","author":"Mayring","year":"2000","journal-title":"Forum Qual. Soc. Res."},{"key":"ref_46","unstructured":"Saldana, J. (2009). The Coding Manual for Qualitative Researchers, Sage Publications."},{"key":"ref_47","unstructured":"Denzin, N.K., and Lincoln, Y.S. (2000). Handbook of Qualitative Research, Sage Publications. [2nd ed.]."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Gale, N.K., Heath, G., Cameron, E., Rashid, S., and Redwood, S. (2013). Using the Framework Method for the Analysis of Qualitative Data in Multi-Disciplinary Health Research. BMC Med. Res. Methodol., 13.","DOI":"10.1186\/1471-2288-13-117"},{"key":"ref_49","first-page":"281.1","article-title":"Using Microsoft Excel to Code and Thematically Analyse Qualitative Data: A Simple, Cost-Effective Approach","volume":"8","author":"Bree","year":"2016","journal-title":"AISHE J."},{"key":"ref_50","unstructured":"Corden, A., and Sainsbury, R. (2006). Using Verbatim Quotations in Reporting Qualitative Social Research: Researchers\u2019 Views, The Social Policy Research Unit, University of York. Available online: https:\/\/www.york.ac.uk\/inst\/spru\/pubs\/pdf\/verbquotresearch.pdf."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.archger.2018.05.010","article-title":"Gender, self-rated health and functional decline among community-dwelling older adults","volume":"77","author":"Gyasi","year":"2018","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_52","unstructured":"EPICENTRO\u2014Epidemiology for Public Health (2020). La Sorveglianza Passi d\u2019Argento. I Dati per l\u2019Italia. Percezione Dello Stato di Salute, EPICENTRO. Available online: https:\/\/www.epicentro.iss.it\/passi-argento\/dati\/percezione."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.2147\/CIA.S253535","article-title":"Preserving Mobility in Older Adults with Physical Frailty and Sarcopenia: Opportunities, Challenges, and Recommendations for Physical Activity Interventions","volume":"15","author":"Billot","year":"2020","journal-title":"Clin. Interv. Aging"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.2522\/ptj.20080036","article-title":"Impact of health perception, balance perception, fall history, balance performance, and gait speed on walking activity in older adults","volume":"88","author":"Talkowski","year":"2008","journal-title":"Phys. Ther."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1093\/ageing\/afs012","article-title":"The role of cognitive impairment in fall risk among older adults: A systematic review and meta-analysis","volume":"41","author":"Muir","year":"2012","journal-title":"Age Ageing"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Qiu, Y., Wei, K., Zhu, L., Wu, D., and Jiao, C. (2021). The Association of Meteorological Factors with Cognitive Function in Older Adults. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18115981"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1080\/13548506.2015.1096946","article-title":"Older adults\u2019 perceptions of ageing and their health and functioning: A systematic review of observational studies","volume":"21","author":"Warmoth","year":"2016","journal-title":"Psychol. Health Med."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.ijdrr.2017.09.010","article-title":"Seniors\u2019 disaster resilience: A scoping review of the literature, in International","volume":"25","author":"Kwan","year":"2017","journal-title":"Int. J. Disaster Risk Reduct."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1037\/0882-7974.15.4.627","article-title":"Age and emotional response to the Northridge earthquake: A longitudinal analysis","volume":"15","author":"Knight","year":"2000","journal-title":"Psychol. Aging"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.gerinurse.2016.02.014","article-title":"The impact of resilience among older adults","volume":"37","author":"MacLeod","year":"2016","journal-title":"Geriatr. Nurs."},{"key":"ref_61","unstructured":"CENSIS (2017). VII Rapporto Sulla Sanit\u00e0 Pubblica, Privata, e Intermediata, RBM Assicurazione Salute. Available online: https:\/\/www.quotidianosanita.it\/allegati\/allegato2421529.pdf."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Cowley, A., Goldberg, S.E., Gordon, A.L., and Logan, P.A. (2021). Rehabilitation potential in older people living with frailty: A systematic mapping review. BMC Geriatr., 21.","DOI":"10.1186\/s12877-021-02498-y"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.2147\/CIA.S207863","article-title":"Challenging rehabilitation environment for older patients","volume":"14","author":"Tijsen","year":"2019","journal-title":"Clin. Interv. Aging"},{"key":"ref_64","first-page":"5","article-title":"La solitudine dei numeri ultimi","volume":"1","author":"Ranci","year":"2020","journal-title":"Abit. Anziani"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1111\/j.1365-2648.2005.03482.x","article-title":"Older people\u2019s willingness to use home care nursing services","volume":"51","author":"Cho","year":"2005","journal-title":"J. Adv. Nurs."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1353\/dem.0.0066","article-title":"Investigating the Mechanism of Marital Mortality Reduction: The Transition to Widowhood and Quality of Health Care","volume":"46","author":"Jin","year":"2009","journal-title":"Demography"},{"key":"ref_67","unstructured":"Sowa-Kofta, A., Marcinkowska, I., Ruzik-Sierdzi\u0144ska, A., and Mackevi\u010di\u016bt\u0117, R. (2021). Ageing Policies. Access to Services in Different Member States, Committee on Employment and Social Affairs, European Parliament. Available online: https:\/\/www.europarl.europa.eu\/RegData\/etudes\/STUD\/2021\/662940\/IPOL_STU(2021)662940_EN.pdf."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1007\/s10900-013-9681-1","article-title":"Traveling towards disease: Transportation barriers to health care access","volume":"38","author":"Syed","year":"2013","journal-title":"J. Commun. Health"},{"key":"ref_69","first-page":"LPS.06","article-title":"Ageing in place and the built environment. Implications for the quality of life and the risks of isolation of frail older people","volume":"4","author":"Sarlo","year":"2019","journal-title":"DAStU Work. Pap. Ser."},{"key":"ref_70","first-page":"LPS.20","article-title":"Ageing in place e contesto abitativo. I condizionamenti dell\u2019ambiente costruito sulla qualit\u00e0 della vita e sui rischi di isolamento degli anziani fragili che invecchiano soli a casa propria: Barriere, mobilit\u00e0, socialit\u00e0","volume":"6","author":"Martinelli","year":"2021","journal-title":"DAStU Work. Pap. Ser."},{"key":"ref_71","unstructured":"Stiglitz, G.E., and Rosengard, J.K. (2015). Economics of the Public Sector. Fourth Edition, Norton & Company Inc."},{"key":"ref_72","first-page":"WPS189361","article-title":"Overcoming Public Sector Inefficiencies toward Universal Health Coverage","volume":"53","author":"Banzon","year":"2018","journal-title":"ADB Work. Pap. Ser."},{"key":"ref_73","unstructured":"ISTAT (2021). Rapporto BES 2020: Il Benessere Equo e Sostenibile in Italia, ISTAT. Available online: https:\/\/www.istat.it\/it\/files\/\/2021\/03\/BES_2020.pdf."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"306","DOI":"10.3399\/bjgp20X710345","article-title":"GP home visits: Essential patient care or disposable relic?","volume":"70","author":"Mitchell","year":"2020","journal-title":"Br. J. Gen. Pract."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Theile, G., Kruschinski, C., Buck, M., M\u00fcller, C.A., and Hummers-Pradier, E. (2011). Home visits\u2014Central to primary care, tradition or an obligation? A qualitative study. BMC Fam. Pract., 12.","DOI":"10.1186\/1471-2296-12-24"},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Hansen, A.H., Kristoffersen, A.E., Lian, O.S., and Halvorsen, P.A. (2014). Continuity of GP care is associated with lower use of complementary and alternative medical providers: A population-based cross-sectional survey. BMC Health Serv. Res., 14.","DOI":"10.1186\/s12913-014-0629-7"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"e002762","DOI":"10.1136\/bmjopen-2013-002762","article-title":"Factors affecting patients\u2019 trust and confidence in GPs: Evidence from the English national GP patient survey","volume":"3","author":"Croker","year":"2013","journal-title":"BMJ Open"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1136\/bmj.324.7342.880","article-title":"Evolving general practice consultation in Britain: Issues of length and context","volume":"324","author":"Freeman","year":"2002","journal-title":"BMJ"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1370\/afm.1160","article-title":"Continuity and trust in primary care: A qualitative study informed by game theory","volume":"8","author":"Tarrant","year":"2010","journal-title":"Ann. Fam. Med."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"e484","DOI":"10.3399\/bjgp11X588457","article-title":"Holding relationships in primary care: A qualitative exploration of doctors\u2019 and patients\u2019 perceptions","volume":"61","author":"Cocksedge","year":"2011","journal-title":"Br. J. Gen. Pract."},{"key":"ref_81","unstructured":"Cittadinanzattiva-Federfarma (2019). Rapporto Annuale Sulla Farmacia. IIa Edizione, Cittadinanzattiva-Federfarma. Available online: https:\/\/www.federfarma.it\/Documenti\/notizie_speciali\/Rapporto_Annuale_Farmacie_2019.aspx+."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1111\/ijpp.12127","article-title":"Pharmaceutical care of older people: What do older people want from community pharmacy?","volume":"23","author":"Wood","year":"2015","journal-title":"Int. J. Pharm. Pract."},{"key":"ref_83","unstructured":"ISTAT (2020). Aspetti di Vita Degli over 75, ISTAT. Available online: https:\/\/www.istat.it\/it\/files\/\/2020\/04\/statisticatoday_ANZIANI.pdf."},{"key":"ref_84","unstructured":"Vicarelli, G., and Giarelli, G. (2021). Il Servizio Sanitario Nazionale e la Pandemia da Covid-19. Problemi e Proposte, Franco Angeli."},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Matranga, D., and Maniscalco, L. (2022). Inequality in Healthcare Utilization in Italy: How Important Are Barriers to Access?. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19031697"},{"key":"ref_86","unstructured":"Spandonaro, F., and D\u2019Angela, D. (2017). Una Misura di Performance dei SSR, V Edizione, Sidera Edizioni. Available online: https:\/\/www.creasanita.it\/images\/performancessr\/Libro-Performance-V-Edition.pdf."},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Fisher, O., Fabbietti, P., and Lamura, G. (2021). Socio-Economic Predictors of Hiring Live-In Migrant Care Workers to Support Community Dwelling Older Adults with Long-Term Care Needs: Recent Evidence from a Central Italian Region. Sustainability, 13.","DOI":"10.3390\/su13105349"},{"key":"ref_88","unstructured":"European Commission (2021). Green Paper on Ageing, Publications Office of the European Union. Available online: https:\/\/ec.europa.eu\/info\/sites\/default\/files\/1_en_act_part1_v8_0.pdf."},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Lincoln, Y.S., and Guba, E.G. (1985). Naturalistic Inquiry, Sage Publications.","DOI":"10.1016\/0147-1767(85)90062-8"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1016\/j.ijnurstu.2010.06.004","article-title":"Generalization in Quantitative and Qualitative Research: Myths and Strategies","volume":"47","author":"Polit","year":"2010","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_91","first-page":"1","article-title":"Reducing Confusion about Grounded Theory and Qualitative Content Analysis: Similarities and Differences","volume":"19","author":"Cho","year":"2014","journal-title":"Qual. Rep."},{"key":"ref_92","first-page":"LPS.10","article-title":"Ageing in place in different care regimes. The role of care arrangements and the implications for the quality of life and social isolation of frail older people","volume":"3","author":"Costa","year":"2020","journal-title":"DAStU Work. Pap. Ser."},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Hagen, B.N.M., Sawatzky, A., Harper, S.L., O\u2019Sullivan, T.L., and Jones-Bitton, A. (2021). What Impacts Perceived Stress among Canadian Farmers? A Mixed-Methods Analysis. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18147366"},{"key":"ref_94","unstructured":"Pesaresi, F. (2022, April 15). Le Case della Comunit\u00e0: Cosa Prevede il PNRR. Welforum.it 2021. Available online: https:\/\/welforum.it\/il-punto\/verso-un-welfare-piu-forte-ma-davvero-coeso-e-comunitario\/le-case-della-comunita-cosa-prevede-il-pnrr\/."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"e018653","DOI":"10.1136\/bmjopen-2017-018653","article-title":"Understanding frailty: A qualitative study of European healthcare policy-makers\u2019 approaches to frailty screening and management","volume":"8","author":"Gwyther","year":"2018","journal-title":"BMJ Open"},{"key":"ref_96","unstructured":"European Commission and Social Protection Committee (2021). Long-Term Care Report. Trends, Challenges and Opportunities in an Ageing Society, Publications Office of the European Union. Available online: https:\/\/ec.europa.eu\/social\/main.jsp?catId=738&langId=en&pubId=8396."},{"key":"ref_97","unstructured":"Melchiorre, M.G., Quattrini, S., Papa, R., Barbabella, F., Zanetti, E., and Lamura, G. (2014). Caring for People with Multiple Chronic Conditions in Italy: Policy and Practices, NIVEL. Available online: http:\/\/www.icare4eu.org\/pdf\/Country_Factsheet_Italy_ICARE4EU.pdf."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/15\/9063\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:56:18Z","timestamp":1760140578000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/15\/9063"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,25]]},"references-count":97,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["ijerph19159063"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19159063","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,25]]}}}