Today, with the occurrence of population aging phenomenon, especially in developing countries, the nature and type of health services have been affected. It has often increased the use of health services and has changed the management and patterns of utilization of health systems resources (1). One of the suitable systems for providing health services to the elderly, which has attracted attention, is the integrated service system (2). This system has been developed as a tool to improve access, quality, and continuity of services in a more efficient way, especially for people with complex needs, and as a strategy to transform the current fragmented systems of primary care to provide better care for the elderly in society (3). According to the World Health Organization (WHO), the "integrated geriatric health care system" has been recommended and put on the agenda by many developed countries. This system is so essential that 41% of the elderly reported some problems due to not receiving integrated care (4, 5).
In the integrated care system, the management and delivery of health services should be such that chain customers receive a chain of preventive and curative services according to their needs over time and at different levels of health. This system requires attention to several dimensions that play a role in service delivery structure and processes (7). So far, many variables have been identified in the effectiveness of the integrated care approach. According to several studies, the influential variables in the level of primary care include a clinical information system and a multidisciplinary team, case management, systematic risk screening, medication assessment, geriatric education, and the elderly self-care program (8).
Currently, in most developed countries, such as Canada, Sweden, the United States, and Japan, the integrated care system has been selected to provide care for the elderly because some administrative, political, financial, and clinical problems of fragmented or integrated care systems have led the system towards an integrated (customer-centric) system (4). It is noteworthy that based on the available evidence, the implementation of integrated health care has increased patient satisfaction, improved health and quality of life, and increased access to health care (5).
However, it seems that the use of these services has changed as a result of the COVID-19 pandemic. This disease is currently very prevalent in most countries of the world and has spread rapidly in Iran, and with its high prevalence has affected many people (9). One of the high-risk groups is the elderly, and it seems that old age and underlying diseases are an important factor in increasing hospitalization and mortality due to COVID-19 (10). Thus, the strategy of governments around the world is to target the elderly and try to persuade them to follow public health preventive measures (11).
Given the high mortality rate among the elderly and the clear goal of governments worldwide, it is reasonable to expect older people to play an active role in preventing COVID-19. On the other hand, the elderly, due to physical, mental, and social health problems, despite the existing limitations, need to receive related care, and delayed care for the elderly can also endanger their health (12 ). However, there is little information on the status of integrated geriatric care services after the recent crisis and changes in the service delivery process. Therefore, this study aimed to evaluate and compare the status of utilization of integrated health geriatric care services at the level of primary health care before and after the COVID-19 pandemic.