A Scoping Review of the Current Status of Continuity of Care Needs and Factors Influencing Them in Elderly Hip Fracture Patients in China

Yu Zhang^1*Xi Chen²Yingqi Zhang²Yu Liu²Haijiao Zhang^2*

• ¹Ningxia Clinical Research Institute,People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China, 750002, Yinchuan, China
• ²People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China

Objective: To apply scientific methods to synthesize existing research, aiming to clarify the current status of continuity of care needs and their core influencing factors among elderly hip fracture patients, thereby providing a theoretical basis for constructing a patient-needs-based continuity of care program. This review specifically focuses on the Chinese context to provide evidence for developing tailored interventions within China's healthcare system. Methods: The review was conducted following the PRISMA-ScR framework. Literature on the current status of continuity of care needs and influencing factors in elderly hip fracture patients 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. Results: Seventeen studies were ultimately included: nine cross-sectional studies and eight qualitative studies. The results indicated that the demand rate for continuity of care among elderly hip fracture patients 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. Conclusion: The findings, primarily based on Chinese studies, indicate a high level of unmet CoC needs among elderly hip fracture patients in China. Furthermore, research specifically developing continuity of care programs tailored to identified patient needs is currently lacking. It underscores the imperative for future research to develop specific assessment tools and construct effective, needs-based CoC programs.