Transition of care in pediatric surgery

Abstract

Objective: To identify among pediatric surgeons across Brazil how the transition of pediatric patients to adult clinics is carried out. Methods: A questionnaire was emailed to pediatric surgeons registered with the Associação Brasileira de Cirurgia Pediátrica in 2018. The data assessed included training time, maximum age of care, subspecialty of practice, outpatient follow-up of adult patients, reason for continuing care of adult patients, referral to adult specialties, concern with transition of care, and what has been done to improve it. Results: Most pediatric surgeons had more than 20 years of experience, and approximately 61% worked simultaneously at a public hospital, private hospital and private office. The maximum age of care at public, private hospitals and private offices proved to be quite varied. The follow-up of patients aged over 18 years at public hospitals, private hospitals and private clinics wase 32%, 23.58% and 20.75%, respectively. The main reason for patients aged over 18 years continued to be accompanied by pediatric surgeons was lack of knowledge about the disease by adult specialties. Most patients were referred to the adult specialty of the hospital, and roughly 37% of pediatric surgeons responded that they were in contact with the adult specialty. Most believed in autonomy of care of their patients and were concerned with transition of care. Conclusion: Transition of care is a relevant issue that needs to be studied and debated to ensure an appropriate long-term follow-up.

Pediatric Bowel Management Options and Organizational Aspects

“…The transition should have a standardized structure to ensure that patients switch from pediatric to adult healthcare providers without interruptions. To allow for a coordinated transition, it is crucial to ensure that healthcare providers, patients, and their families are prepared for the transition of care [ 47 , 85 ].…”