https://elderslab.github.io/author/xinyuhuang/XinyuhuangHugo Blox Builder (https://hugoblox.com)en-usFri, 15 May 2026 00:00:00 +0000https://elderslab.github.io/media/icon_hu11734318148517933569.pnghttps://elderslab.github.io/author/xinyuhuang/https://elderslab.github.io/publication/jing_liao_2026_the_post-screening/Fri, 15 May 2026 00:00:00 +0000https://elderslab.github.io/publication/jing_liao_2026_the_post-screening/<h1 id="abstract"><strong>Abstract</strong></h1> <h3 id="objectives">Objectives</h3> <p>To address the rising burden of dementia, China has prioritized the integration of cognitive care frameworks within primary care (PC). However, a functional gap persists: while screening has expanded, subsequent clinical management remains fragmented. This study investigates the structural and behavioral discontinuity contributing to the post-screening care gap in community-based geriatric care.</p> <h3 id="methods">Methods</h3> <p>Adopting a qualitative exploratory design, this study was conducted across PC facilities in Guangdong, China, between February and August 2022. Through purposive sampling, 104 key stakeholders – including frontline clinicians (n=55), program coordinators (n=21), and health administrators (n=28) – were recruited. Data collected via semi-structured interviews and focus groups underwent rigorous thematic synthesis to map systemic bottlenecks in the care pathway.</p> <h3 id="results">Results</h3> <p>Theme analysis revealed a tripartite architecture of service discontinuity. First, individuals’ behavioral choices during screening process, characterized by procedural fragmentation, disrupt the transition from initial detection to definitive diagnosis. Second, multiple institutional governance dilemmas – stemming from chronic resource scarcity and governance constraints – undermine the delivery of sustained interventions. Finally, cultural resistance creates a stalemate where deep – seated stigma fuels family avoidance and provider reluctance. Collectively, these forces fracture the management loop, preventing the realization of a continuum of care.</p> <h3 id="conclusions">Conclusions</h3> <p>Closing these gaps requires more than expanding screening coverage. To bridge these multi-layered gaps, policy interventions must foster intersectoral synergy, transforming isolated diagnostic encounters into unified, longitudinal care pathways.</p> <p>Keywords: cognitive impairment ; screening; integrated care; primary healthcare; discontinuity</p>