Changes in Hospitalization Patterns Among Patients With Congenital Heart Disease During the Transition From Adolescence to Adulthood

Gurvitz, Michelle; Inkelas, Moira; Lee, Maggie; Stout, Karen; Escarce, José J.; Chang, Ruey‐Kang R.

doi:10.1016/j.jacc.2006.09.051

Cited by 153 publications

(75 citation statements)

References 12 publications

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“…The results of a 1988 National Health Survey revealed that 4% of all children with SHCN were hospitalized, and 2% of those with severe chronic conditions accounted for 27% of all hospital bed days. 5 Or, stated differently, a small percentage of patients are admitted most frequently and stay the longest in the hospital. Further, transition for those with significant cognitive delay was more difficult, because of the lack of adult-oriented providers who are willing to care for the patient and work collaboratively with the family.…”

Section: Resultsmentioning

confidence: 99%

Transition of care: What Is the pediatric hospitalist's role? An exploratory survey of current attitudes

Collins

Reiss

Saïdi

2011

Journal of Hospital Medicine

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OBJECTIVE:Survey of current attitudes of pediatric hospitalists related to transition of care.METHODS:We developed and piloted a survey that was validated by an expert on transition. It was introduced it to the AAP/Pediatric Hospital Medicine Listserv using Survey MonkeyTM. Any participant who agreed to the informed consent was included in the survey.RESULTS:Patients aged 16–17 with chronic medical conditions were taken care of by pediatric hospitalists 70% of the time. Patients aged 18–20 were cared for by pediatric hospitalists 36.8% of the time. Advantages of hospitalist participation in healthcare transition include improved continuity of care and quality of care. The biggest impediments might be lack of time and resources. Most surveyed would be interested in a web based educational module to develop their understanding of healthcare transition.CONCLUSION:The survey provides a snapshot of current attitudes of pediatric hospitalist involvement in transition of care. Pediatric hospitalists are interested in participating in healthcare transition. Although more research is needed to compare current models of transition services and a hospitalist model, the perception for inpatients is that better quality of care can be expected. Targeted educational modules might provide a foundation for pediatric hospitalists to build their scope of practice to include transition services. Journal of Hospital Medicine 2012. © 2011 Society of Hospital Medicine

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Section: Resultsmentioning

confidence: 99%

Transition of care: What Is the pediatric hospitalist's role? An exploratory survey of current attitudes

Collins

Reiss

Saïdi

2011

Journal of Hospital Medicine

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“…13 In the United States, this proportion is expected to be significantly less, and care gaps and dispersion have been documented. 14,15 Despite specialized care for all ACHD patients being espoused by societal guidelines, 9,10 there is little evidence demonstrating that this model of care improves clinical outcomes.…”

Section: Editorial See P 1795 Clinical Perspective On P 1812mentioning

confidence: 99%

Specialized Adult Congenital Heart Disease Care

et al. 2014

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Background-Clinical guidelines recommend specialized care for adult congenital heart disease (ACHD) patients. In reality, few patients receive such dedicated care. We sought to examine the impact of specialized care on ACHD patient mortality. Methods and Results-We examined referral rates to specialized ACHD centers and ACHD patient mortality rates between 1990 and 2005 in the population-based Quebec Congenital Heart Disease database (n=71 467). This period covers several years before and after the publication of guidelines endorsing specialized care for ACHD patients. A time-series design, based on Joinpoint and Poisson regression analyses, was used to assess the changes in annual referral and patient mortality rates. The association between specialized ACHD care and all-cause mortality was assessed in both case-control and cohort studies. The time-series analysis demonstrated a significant increase in referral rates to specialized ACHD centers in 1997 (rate ratio, +7.4%; 95% confidence interval [CI], +6.6% to +8.2%). In parallel, a significant reduction in expected ACHD patient mortality was observed after year 2000 (rate ratio, −5.0%;95% CI, −10.8% to −0.8%). In exploratory post hoc cohort and case-control analyses, specialized ACHD care was independently associated with reduced mortality (hazard ratio, 0.78; 95% CI, 0.65-0.94) and a reduced odds of death (adjusted odds ratio, 0.82; 95% CI, 0.08-0.97), respectively. This effect was predominantly driven by patients with severe congenital heart disease (hazard ratio, 0.38; 95% CI, 0.22-0.67). Conclusions-A significant increase in referrals to specialized ACHD centers followed the introduction of the clinical guidelines. Moreover, referral to specialized ACHD care was independently associated with a significant mortality reduction. Our findings support a model of specialized care for all ACHD patients. (Circulation. 2014;129:1804-1812.)

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“…Estimates suggest there are more than 1 million adults with CHD living in the United States: these patients have high rates of overall health care resource utilization [1], emergency room visits [2], increasing numbers of hospitalizations [3] and are at particular risk for becoming lost to congenital heart care as they enter adulthood [4].…”

Section: Introductionmentioning

confidence: 99%

Improving heart disease knowledge and research participation in adults with congenital heart disease (The Health, Education and Access Research Trial: HEART-ACHD)

Valente¹,

Landzberg²,

Gianola³

et al. 2013

International Journal of Cardiology

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Changes in Hospitalization Patterns Among Patients With Congenital Heart Disease During the Transition From Adolescence to Adulthood

Cited by 153 publications

References 12 publications

Transition of care: What Is the pediatric hospitalist's role? An exploratory survey of current attitudes

Transition of care: What Is the pediatric hospitalist's role? An exploratory survey of current attitudes

Specialized Adult Congenital Heart Disease Care

Improving heart disease knowledge and research participation in adults with congenital heart disease (The Health, Education and Access Research Trial: HEART-ACHD)

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