Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Lancet Child Adolesc Health. 2019 Nov;3(11):822-830. doi: 10.1016/S2352-4642(19)30266-4. Epub 2019 Sep 18.
The epidemiological transition towards non-communicable diseases is characterised by an upward shift in age of disease burden across the lifecourse. One response, within a suite of wider actions, would be to extend the upper age limit of paediatric practice to embrace adolescent health. We did an online survey to explore the upper age limit of paediatric care, obtaining responses from 1372 paediatricians in 115 countries. Marked variation in the upper age limit was apparent. Among high-income countries, a higher upper age limit was associated with greater disease burden in adolescents relative to young children (<5 years). Although paediatricians reported the mean upper age limit of paediatrics had risen over the past 20 years, the mean preferred age of 18·7 (SD 2·6) years was higher than the mean current age of 17·4 (SD 2·5) years (p<0·0001). Paediatricians reported the main reasons for the rising age over time was their greater awareness of adolescent health and leadership by professional associations. Reports of the quality of adolescent health education within national paediatric training suggest that this education is largely inadequate. A greater focus on adolescent health is required within paediatrics to ensure that the future paediatric workforce is appropriately equipped to respond to the changing disease burden across childhood and adolescence.
非传染性疾病的流行病学转变的特点是疾病负担在整个生命历程中的年龄呈上升趋势。应对措施之一是将儿科实践的上限年龄延长，以涵盖青少年健康。我们进行了一项在线调查，以探讨儿科护理的上限年龄，从 115 个国家的 1372 名儿科医生那里获得了回应。上限年龄明显存在差异。在高收入国家，与幼儿（<5 岁）相比，青少年的疾病负担越高，上限年龄越高。尽管儿科医生报告说，过去 20 年来儿科的平均上限年龄有所上升，但他们更倾向于将 18.7 岁（SD 2.6）作为上限年龄，而目前的平均年龄为 17.4 岁（SD 2.5）（p<0.0001）。儿科医生报告说，上限年龄随时间推移而上升的主要原因是他们对青少年健康的认识提高，以及专业协会的领导。关于国家儿科培训中青少年健康教育质量的报告表明，这种教育在很大程度上是不够的。需要在儿科学中更加关注青少年健康，以确保未来的儿科劳动力能够适应儿童和青少年时期不断变化的疾病负担。
