Graves Laurie, Leung Shannon, Raghavendran Prashant, Mennito Sarah
From the Departments of Internal Medicine and Pediatrics, Medical University of South Carolina, Charleston.
South Med J. 2019 Sep;112(9):497-499. doi: 10.14423/SMJ.0000000000001017.
The transition of care between pediatric and adult medicine is a challenging time for patients and physicians. This longitudinal process encompasses much more than the physical transfer of a patient between providers. Established transition of care processes and literature exist for many chronic disease populations, but little focus has been directed toward the transition of care and the delivery of preventive medicine for healthy young adult patients. The 18- to 30-year-old age group is a heterogenous population that often engages in high-risk behaviors and has high rates of preventable morbidity and mortality. A significant number of these patients do not receive routine primary care and are high users of costly emergency services. Without a continuous source of care, many young adults do not receive age-appropriate screening or preventive health guidance. Structured transition practices improve outcomes in the chronic disease population, and anticipatory guidance has a positive effect on patient lifestyle modification. Adult providers should use these practices to ensure the successful integration of healthy young adult patients into an adult medical home. By establishing an ongoing source of preventive care, providers could reduce morbidity and mortality in this vulnerable population.
儿科与成人医学之间的医疗护理过渡，对患者和医生来说都是一段充满挑战的时期。这个纵向过程所涵盖的远不止是患者在不同医疗服务提供者之间的实际转移。针对许多慢性病患者群体，已有既定的医疗护理过渡流程和相关文献，但对于健康的年轻成年患者的医疗护理过渡及预防医学服务的提供，关注却很少。18至30岁的年龄组是一个异质性群体，他们常常有高风险行为，可预防的发病率和死亡率也很高。这些患者中有相当一部分没有接受常规初级护理，且大量使用昂贵的急诊服务。由于缺乏持续的医疗护理来源，许多年轻人没有接受适合其年龄的筛查或预防性健康指导。结构化的过渡措施可改善慢性病患者群体的治疗效果，而预期性指导对患者的生活方式改变有积极影响。成人医疗服务提供者应采用这些措施，以确保健康的年轻成年患者成功融入成人医疗之家。通过建立持续的预防护理来源，医疗服务提供者可以降低这一脆弱群体的发病率和死亡率。
