Health Resources and Services Administration, Maternal and Child Health Bureau, Rockville, Maryland;
The National Alliance to Advance Adolescent Health and Got Transition, Washington, DC; and.
Pediatrics. 2018 Oct;142(4). doi: 10.1542/peds.2018-0194. Epub 2018 Sep 17.
Researchers have shown that most youth with special health care needs (YSHCN) are not receiving guidance on planning for health care transition. This study examines current transition planning among US youth with and without special health care needs (SHCN).
The 2016 National Survey of Children's Health is nationally representative and includes 20 708 youth (12-17 years old). Parents and/or caregivers were asked if transition planning occurred, based on the following elements: (1) doctor or other health care provider (HCP) discussed the eventual shift to an HCP who cares for adults, (2) an HCP actively worked with youth to gain self-care skills or understand changes in health care at age 18, and (3) youth had time alone with an HCP during the last preventive visit. Sociodemographic and health system characteristics were assessed for associations with transition planning.
Nationally, 17% of YSHCN and 14% of youth without SHCN met the overall transition measure. Older age (15-17 years) was the only sociodemographic factor associated with meeting the overall transition measure and individual elements for YSHCN and youth without SHCN. Other sociodemographic characteristics associated with transition planning differed among the 2 populations. Receipt of care coordination and a written plan was associated with transition planning for YSHCN.
This study reveals that few youth with and without SHCN receive transition planning support. It underscores the need for HCPs to work with youth independently and in collaboration with parents and/or caregivers throughout adolescence to gain self-care skills and prepare for adult-focused care.
研究人员表明,大多数有特殊医疗需求的青年(YSHCN)并未获得有关医疗过渡规划的指导。本研究考察了美国有特殊医疗需求(SHCN)和无特殊医疗需求(SHCN)的青年当前的过渡规划情况。
2016 年全国儿童健康调查具有全国代表性,共纳入 20708 名(12-17 岁)青年。根据以下要素,询问家长和/或照顾者是否进行了过渡规划:(1)医生或其他医疗保健提供者(HCP)讨论了最终向照顾成人的 HCP 的转变;(2)HCP 积极与青年合作,培养自我护理技能或了解 18 岁时的医疗保健变化;(3)在最近一次预防性就诊期间,青年有单独与 HCP 相处的时间。评估社会人口统计学和卫生系统特征与过渡规划之间的关联。
在全国范围内,17%的 YSHCN 和 14%的无 SHCN 青年符合总体过渡指标。年龄较大(15-17 岁)是唯一与 YSHCN 和无 SHCN 青年符合总体过渡指标和各个要素相关的社会人口统计学因素。与过渡规划相关的其他社会人口统计学特征在这两个群体中有所不同。接受护理协调和书面计划与 YSHCN 的过渡规划相关。
本研究表明,很少有有特殊医疗需求和无特殊医疗需求的青年获得过渡规划支持。这突显了 HCP 在整个青春期内需要与青年独立合作,并与家长和/或照顾者合作,以培养自我护理技能并为以成人为中心的护理做好准备。