Survey of Primary Care Pediatricians on the Transition and Transfer of Adolescents to Adult Health Care

Burke, Robert; Spoerri, Michael; Price, Ashley; Cardosi, Ann-Marie; Flanagan, Patricia

doi:10.1177/0009922807310938

Cited by 48 publications

(52 citation statements)

References 19 publications

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“…Many physicians are not trained in caring for YSHCN, especially youth with behavioral and/or communication challenges. 5,31,32 Few physicians and medical practitioners are trained in the importance of and procedures for HCT, and the time required to provide these services is not financially reimbursable. 5,31 Furthermore, in many regions, there is a paucity of adult providers with an understanding of developmental disabilities, such as ASD, and its associated conditions.…”

Section: Discussionmentioning

confidence: 99%

Disparities in Transition Planning for Youth With Autism Spectrum Disorder

Cheak‐Zamora¹,

Yang²,

Farmer

et al. 2013

Pediatrics

109

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WHAT'S KNOWN ON THIS SUBJECT: Health care transition services assist youth with special health care needs (YSHCN) in transitioning to adult care without gaps in services or health insurance coverage. Less than half of YSHCN receive anticipatory assistance in this transition; receipt of these services for youth with autism spectrum disorder is unknown. WHAT THIS STUDY ADDS:Youth with autism spectrum disorder receive transition services half as often as youth with special health care needs. Quality of health care is associated with increased receipt of health care transition services. Presence of comorbid conditions decreased receipt of transition services. abstract OBJECTIVE: Little is known about accessibility to health care transition (HCT) services for youth with autism spectrum disorder (ASD). This study expands our understanding by examining the receipt of HCT services in youth with ASD compared with youth with other special health care needs (OSHCN). METHODS:We used the 2005-2006 National Survey of Children with Special Health Care Needs to examine receipt of HCT services for youth (aged 12-17 years) with ASD and youth with OSHCN. Logistic regression analyses explored whether individual, family, or health system factors were associated with receipt of HCT services for youth with ASD. RESULTS:Whereas half of youth with OSHCN received HCT services, less than a quarter of youth with ASD did. Only 14% of youth with ASD had a discussion with their pediatrician about transitioning to an adult provider, less than a quarter had a discussion about health insurance retention, and just under half discussed adult health care needs or were encouraged to take on appropriate responsibility. Logistic regression analyses indicated that having a developmental disability or multiple health conditions in addition to ASD and quality of health care were strong predictors of HCT, whereas demographic and family variables accounted for little variance. CONCLUSIONS:Youth with ASD experience disparities in access to HCT services. Youth with comorbid conditions are at greatest risk for poor access to HCT services and increased quality of care has a positive effect. Research is needed to understand barriers to care and develop policy and practice guidelines tailored for youth with ASD. Pediatrics 2013;131:447-454

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Section: Discussionmentioning

confidence: 99%

Disparities in Transition Planning for Youth With Autism Spectrum Disorder

Cheak‐Zamora¹,

Yang²,

Farmer

et al. 2013

Pediatrics

109

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“…Even patients who continue to see the same healthcare providers for CHD care should undergo a process of transition similar to that provided by family practitioners and internal medicine/pediatric specialists who do not transfer patient care. 28 Before transfer to ACHD care, ensure that any ongoing medical or surgical issues are addressed. A portable and accessible summary of medical history allows for effective collaboration among healthcare providers.…”

Section: Timing Of Transitionmentioning

confidence: 99%

Best Practices in Managing Transition to Adulthood for Adolescents With Congenital Heart Disease: The Transition Process and Medical and Psychosocial Issues

Sable¹,

Foster²,

Uzark³

et al. 2011

Circulation

387

280

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“…This in turn has led to higher numbers crossing over from paediatric to adult care;, yet transition-related research is sparse even in physical disorders [31,33]. A recent review of transitions in diabetes reported that published studies have major limitations imposed by small sample sizes and selection bias.…”

Section: Transition In Physical Healthmentioning

confidence: 99%

Transition of care from child to adult mental health services: the great divide

Singh

2009

Current Opinion in Psychiatry

208

190

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Purpose of the review: Adolescents with mental health problems often require transition of care from child and adolescent (CAMHS) to adult mental health services (AMHS). This review is a synthesis of current research and policy literature on transition to determine the magnitude of the problem, barriers at the interface between CAMHS and AMHS and outcomes of poor transition.Recent Findings: Adolescence is a risk period for emergence of serious mental disorders. CAMHS and AMHS use rigid age cut-offs to delineate service boundaries, creating discontinuities in provision of care. Adolescent mental health services are patchy across the world. Several recent studies have confirmed that problems occur during transition in diverse settings across several countries. In physical health, there are emerging models of practice to improve the process and outcomes of transition, but there is very little comparable literature in mental health care.Summary Poor transition leads to disruption in continuity of care, disengagement from services and is likely to lead to poorer outcomes. Some young people, such as those with neurodevelopmental disorders and complex needs, are at a greater risk of falling through the care gap during transition. Services need robust and high quality evidence on the process and outcomes of transition so that effective intervention strategies can be developed.

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Survey of Primary Care Pediatricians on the Transition and Transfer of Adolescents to Adult Health Care

Cited by 48 publications

References 19 publications

Disparities in Transition Planning for Youth With Autism Spectrum Disorder

Disparities in Transition Planning for Youth With Autism Spectrum Disorder

Best Practices in Managing Transition to Adulthood for Adolescents With Congenital Heart Disease: The Transition Process and Medical and Psychosocial Issues

Transition of care from child to adult mental health services: the great divide

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