DOI: 10.3390/healthcare14213670 ISSN: 2227-9032

Primary and Community-Based Home Care Services for Older Adults: A Scoping Review of Eligibility Criteria and Homebound Status

Dimitra Iosifina Papageorgiou, Stella Ploukou, Nikolaos Vlachopoulos, Anna Bettina Haidich, Emmanouil Smyrnakis

Background/Objectives: Home-based primary care and community health services can facilitate ageing in place. However, the eligibility criteria for these services vary widely, and how consistently homebound status is identified remains unclear. This scoping review explored the existing literature on primary care or community care home-delivered services for adults aged 60 and older. This paper, the first of two reporting findings from the same review protocol, examines the eligibility criteria used to identify candidates for such care and the extent to which study populations meet homebound criteria. Methods: A scoping review of MEDLINE, Cochrane Central Register of Controlled Trials, Scopus, ClinicalTrials.gov, ProQuest (grey literature) and hand-searching of the citation list was conducted up to February 2026. The study protocol was prospectively registered. Reporting followed the PRISMA-ScR guidelines. Results: We screened 2834 records (initial and updated searches) and 64 studies published between 1990 and 2026 were included. Eligibility criteria varied substantially, most commonly based on cognitive status, functional dependency, or frailty, though inconsistently defined. Homebound status was rarely reported (11 studies). Applying a classification framework developed for this review, an additional six studies were classified as possibly homebound and 27 studies as at-risk of homebound, without being labelled as such, a pattern extending beyond frailty-related groups to psychosocially vulnerable and general older populations. Conclusions: Eligibility criteria for home-based care are inconsistently defined and reported. Homebound status is rarely reported, even in populations that appear to meet homebound or at-risk criteria. Future research should examine whether a validated primary care screening tool can identify homebound risk earlier.

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