title: Continuity of Care for Older Adults with Chronic Illness in China: An Exploratory Study.
abstract: OBJECTIVE
  To explore nurses' understanding of continuity of care and existing problems in implementation of continuity of care for Chinese elders with chronic illnesses.
  
  
  METHODS
  Cross-sectional survey and semi-structured interview were performed on 15 nurses and older patients and 1,902 older patients between July 2010 and February 2011.
  
  
  METHODS
  Semi-structured interview guideline and four-section scale were used.
  
  
  RESULTS
  The interviews showed nurses lacked knowledge of continuity of care, and nurses from small towns or rural areas had less understanding of continuity of care and discharge planning than nurses from central cities. Significant differences were found among patients located in referred areas in selection of medical institutions for treatment, suggesting older adults were more likely to choose general hospitals for treatment. Self-reported surveys demonstrated more than 70% of hospitalized elders chose community hospitals for further recovery after discharge from general hospitals.
  
  
  CONCLUSIONS
  Chinese nurses lack knowledge of continuity of care, and significant discontinuity exists between health care provided by general hospitals, community hospitals and other institutions for elders. A further model for the development of continuity of care should be established that addresses older patients' demands and current barriers in China.
authors.affiliation: Tianjin Stomatological Hospital of Nankai University, Tianjin, China.
authors.forename: Shu-Ling
authors.initials: SL
authors.lastname: Cheng
authors.affiliation: Seven-Year System of Basic Medical College, Tianjin Medical University, Tianjin, China.
authors.forename: Jin-Zhi
authors.initials: JZ
authors.lastname: Zhao
authors.affiliation: School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Jinbing
authors.initials: J
authors.lastname: Bai
authors.affiliation: School of Nursing, Tianjin Medical University, Tianjin, China.
authors.forename: Xiao-Ying
authors.initials: XY
authors.lastname: Zang
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D002908:Chronic Disease / Q000451:nursing*; D002983:Clinical Competence; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D057184:Practice Patterns, Nurses' / Q000706:statistics & numerical data*; D011637:Public Health Nursing / Q000379:methods*
keywords: chronic illness; continuity of care; older adults