Which populations are particularly at risk for fragmented care?

• A. Older adults, patients with multiple chronic conditions, low health literacy, language barriers, and social isolation.
• B. Young, healthy adults with high health literacy.
• C. Pets and their owners.
• D. Patients with only acute single-visit needs.

Answer: (A)

Fragmented care happens when care across different providers and settings isn’t well connected, leading to gaps, duplicated tests, conflicting instructions, and missed follow-up. This tends to occur most with people who are complex and have barriers to communication and access. Older adults with multiple chronic conditions often need care from several specialists, frequent transitions between hospital, rehab, primary care, and home, and tricky medication regimens, all of which heighten coordination challenges. When health literacy is low, patients may struggle to understand discharge plans, medication labels, or how to navigate the system, increasing the chance of miscommunication and nonadherence. Language barriers hinder clear exchange of information and shared decision making, further breaking continuity. Social isolation removes a support network that helps manage appointments, transportation, and understanding instructions, making fragmentation more likely. In contrast, younger, healthy individuals with high health literacy usually have simpler needs and fewer care transitions, so fragmentation is less common; scenarios involving pets or single acute visits do not inherently create the ongoing coordination demands seen with chronic, multimorbid care.