Gabriel Phabinly, McManus Margaret, Rogers Katherine, White Patience
The National Alliance to Advance Adolescent Health, Washington, DC; Rutgers New Jersey Medical School, Newark, NJ.
The National Alliance to Advance Adolescent Health, Washington, DC.
J Pediatr. 2017 Sep;188:263-269.e15. doi: 10.1016/j.jpeds.2017.05.066. Epub 2017 Jun 28.
To identify statistically significant positive outcomes in pediatric-to-adult transition studies using the triple aim framework of population health, consumer experience, and utilization and costs of care.
Studies published between January 1995 and April 2016 were identified using the CINAHL, Ovid MEDLINE, PubMed, Scopus, and Web of Science databases. Included studies evaluated pre-evaluation and postevaluation data, intervention and comparison groups, and randomized clinic trials. The methodological strength of each study was assessed using the Effective Public Health Practice Project Quality Assessment Tool.
Out of a total of 3844 articles, 43 met our inclusion criteria. Statistically significant positive outcomes were found in 28 studies, most often related to population health (20 studies), followed by consumer experience (8 studies), and service utilization (9 studies). Among studies with moderate to strong quality assessment ratings, the most common positive outcomes were adherence to care and utilization of ambulatory care in adult settings.
Structured transition interventions often resulted in positive outcomes. Future evaluations should consider aligning with professional transition guidance; incorporating detailed intervention descriptions about transition planning, transfer, and integration into adult care; and measuring the triple aims of population health, experience, and costs of care.
运用人群健康、消费者体验以及医疗服务利用和成本的三重目标框架，确定儿科到成人过渡研究中具有统计学意义的积极结果。
使用CINAHL、Ovid MEDLINE、PubMed、Scopus和科学网数据库，检索1995年1月至2016年4月发表的研究。纳入的研究评估了预评估和后评估数据、干预组和对照组以及随机临床试验。使用有效公共卫生实践项目质量评估工具评估每项研究的方法学优势。
在总共3844篇文章中，43篇符合我们的纳入标准。28项研究发现了具有统计学意义的积极结果，其中大多数与人群健康相关（20项研究），其次是消费者体验（8项研究）和服务利用（9项研究）。在质量评估等级为中度到高度的研究中，最常见的积极结果是在成人环境中坚持治疗和利用门诊医疗服务。
结构化的过渡干预措施通常会产生积极结果。未来的评估应考虑与专业过渡指南保持一致；纳入关于过渡计划、转诊和融入成人护理的详细干预描述；并衡量人群健康、体验和医疗成本这三个目标。
