AUTHOR=Zhang Yu , Chen Xi , Zhang Yingqi , Liu Yu , Zhang Haijiao 

TITLE=A scoping review of the current status of continuity of care needs and factors influencing them in older adults with hip fractures in China

JOURNAL=Frontiers in Public Health

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1667307

DOI=10.3389/fpubh.2025.1667307

ISSN=2296-2565

ABSTRACT=ObjectiveTo apply scientific methods to synthesize existing research, aiming to clarify the current status of continuity of care needs and their core influencing factors among older adults with hip fractures, thereby providing a theoretical basis for constructing a patient-needs-based continuity of care program. We posed two explicit research questions: (1) What specific continuity-of-care needs do patients ≥ 65 years old experience after hip fracture? (2) Which individual, caregiver, and system-level factors influence these needs? This review specifically focuses on the Chinese context to provide evidence for developing tailored interventions within China’s healthcare system.MethodsThe review was conducted following the PRISMA-ScR framework. Literature on the current status of continuity of care needs and influencing factors in older adults with hip fractures was retrieved from the following databases: China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP (CQVIP), SinoMed, PubMed, Web of Science, Embase, and The Cochrane Library. The review particularly aimed to synthesize evidence from China. The search timeframe was restricted from database inception to May 9, 2025. Two researchers independently screened the literature, extracted data, and summarized findings.ResultsSeventeen studies were ultimately included: nine cross-sectional studies and eight qualitative studies. The results indicated that the demand rate for continuity of care among older adults with hip fractures ranged from 35.83 to 75.60%. The identified needs were categorized into five main types: (1) needs for accessing hospital and community resources, (2) needs for disease-related knowledge, (3) needs for social support, (4) nutritional needs, and (5) psychological needs. Among these, the needs for accessing hospital/community resources and disease-related knowledge were the most prominent. The influencing factors were categorized into two themes: socio-demographic factors and disease-related factors. Socio-demographic factors included age, education level, and marital status; notably, patients aged <70 years exhibited a higher demand for continuity of care compared to older patients. Disease-related factors included physical condition and lack of disease-related knowledge. One study specifically reported the relationship between discharge readiness and patients’ continuity of care needs.ConclusionThe findings, primarily based on Chinese studies, indicate a high level of unmet CoC needs among older adults with hip fractures in China. Across 48 studies we found seven core needs—real-time information hand-offs, a named navigator, early mobilization, step-wise pain management, home fall-hazard modification, post-fracture depression screening, and standardized 30- to 180-day outcome tracking—driven by patient factors (cognitive impairment, multimorbidity), caregiver factors (education and financial burden), and system factors (EHR interoperability, integrated payment models). The overall demand for continuity of care among older adults with hip fractures is relatively high, with a portion of these needs remaining unmet. Furthermore, research specifically developing continuity of care programs tailored to identify patient needs is currently lacking. The assessment of continuity of care needs in this population primarily relies on self-developed scales, lacking specific, validated instruments. Future research should focus on the development and application of specific assessment tools to more accurately identify the continuity of care needs of older adults with hip fractures. This will facilitate the construction of needs-based continuity of care programs, ultimately enhancing home-based rehabilitation outcomes and strengthening the effectiveness of continuity of care. This review maps the current evidence and reveals a critical gap: while needs are well-documented, there is a stark lack of studies developing and testing interventions based on these needs, particularly within China. It underscores the imperative for future research to develop specific assessment tools and construct effective, needs-based CoC programs.