Abstract
All youth must transition from pediatric to adult-centered medical care. This process
is especially difficult for youth with special health care needs. Many youth do not
receive the age-appropriate medical care they need and are at risk during this vulnerable
time. Previous research has identified barriers that may prevent effective transition,
and protocols have been developed to improve the process. Health outcomes related
to successful transition have yet to be fully defined.
Health care transition can also be influenced by education of providers, but there
are gaps in medical education at the undergraduate, graduate, and postgraduate levels.
Current changes in federal health policy allow improved health care coverage, provide
some new financial incentives, and test new structures for transitional care, including
the evolution of accountable care organizations (ACO). Future work must test how these
systems changes will affect quality of care. Finally, transition protocols exist in
various medical subspecialties; however, national survey results show no improvement
in transition readiness, and there are no consistent measures of what constitutes
transition success.
In order to advance the field of transition, research must be done to integrate transition
curricula at the undergraduate, graduate, and postgraduate levels; to provide advance
financial incentives and pilot the ACO model in centers providing care to youth during
transition; to define outcome measures of importance to transition; and to study the
effectiveness of current transition tools on improving these outcomes.
Keywords
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Article info
Publication history
Accepted:
November 12,
2013
Received:
August 20,
2012
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
