SynthesisNursing open2023
Fragmented care and chronic illness patient outcomes: A systematic review.
Synthesis in Nursing open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
76 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Quality of Primary Healthcare Services in Kazakhstan: A Systematic Review and Meta-Analysis of Patient-Centred Outcomes and Implications for Nursing Practice and Policy.Nursing open · 2026Pooled it
- Implementation Outcomes and Their Determinants for Hospital-Led Care Coordination Interventions Targeting Patients With Complex Care Needs: A Qualitative Systematic Review.Journal of clinical nursing · 2026Pooled it
- Interdisciplinary recommendations for recurrent hyperkalaemia: insights from the GUARDIAN-HK European Steering Committee.European heart journal. Cardiovascular pharmacotherapy · 2025Guideline
- The Impact of Multidisciplinary Transitional Care Interventions for Complex Care Needs: A Systematic Review and Meta-Analysis.The Gerontologist · 2025Pooled it
- Fragmented care and chronic illness patient outcomes: A systematic review.Nursing open · 2023Pooled it
- Recommendations of the Brazilian Society of Nephrology for the management of chronic kidney disease in primary health care.Jornal brasileiro de nefrologiaGuideline
- Legislative compliance in coordinated care transitions: a mixed-method study of healthcare professionals' documentation and older adults' experiences.International journal of qualitative studies on health and well-being · 2026Article
- Continuity in a fragmented healthcare system: - organizational and individual determinants.Scandinavian journal of primary health care · 2026Article
- Healthcare Professionals' Experiences of the Causes of Recurrent Pressure Injuries-A Phenomenographic Study.International wound journal · 2026Article
- Leveraging Artificial Intelligence to Monitor Patients With Prostate Cancer in a Retrospective Cohort of Radiation Oncology Clinic Patients.Clinical journal of oncology nursing · 2026Article
- Shared Decision-Making with Patients with Multimorbidity and Limited Health Literacy: The Importance of Values Clarification.Journal of general internal medicine · 2026Article
- Designing a computerized decision support system for asthma chronic disease management in community pharmacies.International journal of clinical pharmacy · 2026Article
- Geographic Trends and Disparities in Meningioma Mortality: A National Observational Study from 1999 to 2020 Utilizing the CDC Wonder Database.Journal of neurological surgery. Part B, Skull base · 2026Article
- Article
- Examining Barriers to Cancer Care: A Needs Assessment of African American and Black African Immigrants in Iowa.Journal of racial and ethnic health disparities · 2026Article
- Outpatient Care Fragmentation and Patient Satisfaction With Care.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- "That's not my silo": Navigating fragmented long COVID care in the mid-Atlantic United States.SSM. Qualitative research in health · 2026Article
- Exploring pharmacist prescribing practices in general practices for atrial fibrillation in England: a qualitative study using the theoretical domains framework.International journal of clinical pharmacy · 2026Article
- The organization of virtual care centers: A qualitative study in Dutch hospitals.PLOS digital health · 2026Article
- Educating, Contextualizing, and Deferring: Qualitative Investigation of Physician Communication About Chronic Kidney Disease.Healthcare (Basel, Switzerland) · 2026Article
16 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimThis systematic review examined recent studies on fragmented care of patients with chronic illnesses in the United States to examine the association between fragmented care and patient outcomes.
designSystematic review.
methodsStudies published from January 1, 2012, to June 1, 2022, were selected from four electronic databases (PubMed, CINAHL, PsycINFO, and Web of Science), following the Cochrane protocols and PRISMA statements. Based on inclusion and exclusion criteria, ten studies that examined associations published between 2015 and 2021 were selected. A methodological assessment was conducted with the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The studies selected for this systematic review were rated as having fair methodological rigor. The protocol of this review was registered in the International Prospective Register of Systematic Reviews (PROSPERO registration number: CRD42021285379). Because of the heterogeneity of the selected studies' data, a systematic narrative synthesis of the extracted data was conducted.
resultsThree common measures for fragmented care and outcomes were synthesized. A synthesis of the studies found significant association between fragmented care and adverse outcomes of chronic illnesses (emergency department visits, utilization of diagnostic tests, and healthcare costs). Despite the heterogeneity of significant findings between fragmented care and patient outcomes, the relationship between these outcomes and fragmented care was significant. This systematic review provides clear evidence of the association between care fragmentation and its adverse effects on individuals with chronic illnesses. However, mixed relationship findings were also reported.
conclusionGiven the demands of overcoming fragmented care in healthcare settings in the United States, nurse managers, healthcare leaders, and policymakers should utilize this evidence to reduce fragmented care strategies. It is recommended that nurse researchers and other healthcare practitioners conduct further studies to understand the contexts and mechanisms of fragmented care and develop theoretical frameworks for care fragmentation and chronic illness outcomes.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.