{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:04:30Z","timestamp":1793037870002,"version":"4.5.0"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Health Serv."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study provides the first international benchmarking of postoperative hip fracture care in Chinese tertiary hospitals using the UK Fracture Liaison Service (FLS) Key Performance Indicators within a \u201ccascade of care\u201d framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. We conducted a retrospective audit of 2,689 patients aged \u226560 years who received hip fracture surgery in an orthogeriatric co-managed ward from 2016 to 2018. Performance was measured against seven validated FLS KPIs: bone mineral density (BMD) screening, anti-osteoporosis medication initiation, falls risk assessment, rehabilitation provision, follow-up adherence, and secondary fracture incidence at specified time points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Inpatient metrics were excellent: 97.1% (2,610\/2,689) underwent BMD screening and 94.0% (2,454\/2,610) received bone-protective medication prior to discharge, both exceeding UK benchmarks. Post-discharge follow-up declined sharply: 50.7% (1,363\/2,689) at 90 days, 17.7% (477\/2,689) at 12\u201316 weeks, and 9.5% (255\/2,689) at 12 months. Secondary fracture rates remained high (11.0\u201313.4%) across follow-up intervals despite strong treatment initiation. International comparison highlighted strengths in acute inpatient management but exposed deficits in community-based coordination and long-term adherence relative to integrated FLS models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This pioneering international comparison demonstrates that Chinese hospital-centric orthogeriatric co-management delivers outstanding acute care but struggles with sustained secondary fracture prevention due to fragmented healthcare pathways and limited primary care integration. Implementation of dedicated FLS coordinators, digital engagement tools, and structured hospital\u2013community partnerships is essential to build a comprehensive secondary prevention network and reduce long-term fracture risk in China's aging population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/frhs.2026.1799272","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T05:46:02Z","timestamp":1778737562000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["International benchmarking of secondary fracture prevention in older adults with hip fracture: a Chinese hospital-based KPI audit"],"prefix":"10.3389","volume":"6","author":[{"given":"Yuan","family":"Yuan","sequence":"first","affiliation":[{"name":"Department of Geriatrics, Beijing Jishuitan Hospital, Capital Medical University","place":["Beijing, China"]},{"name":"National Center for Orthopaedics","place":["Beijing, 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Beijing Jishuitan Hospital, Capital Medical University","place":["Beijing, China"]},{"name":"National Center for Orthopaedics","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Hui","family":"Yang","sequence":"additional","affiliation":[{"name":"National Center for Orthopaedics","place":["Beijing, China"]},{"name":"Department of Traumatic Orthopedics, Beijing Jishuitan Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Beijing Jishuitan Hospital, Capital Medical University","place":["Beijing, China"]},{"name":"National Center for Orthopaedics","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Public Health, Harbin Medical University","place":["Harbin, 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