Department of Pediatrics, Dalhousie University and the IWK Health Centre, Halifax, Nova Scotia.
Semin Pediatr Neurol. 2020 Dec;36:100858. doi: 10.1016/j.spen.2020.100858. Epub 2020 Oct 26.
Despite an increasing literature, there are many unanswered questions about transition to adult care for youth with chronic disorders. This paper questions the definition and components of optimal transition programs, their effectiveness and costs. Few transition programs have been comprehensively evaluated and effectiveness studies are usually based on a historical control group. Transition clinics for neurological disorders are described but not evaluated. Studies in diabetes, renal transplant, and rheumatologic disorders provide the best available evidence, albeit limited, of the value of transition clinics/programs. A few studies have addressed the cost of transition clinics and suggest that the incremental costs of the clinic are recouped by reduced medical costs in adult care. There is room for a great deal more research about transition.
尽管文献不断增加，但对于患有慢性疾病的青年向成人护理过渡的问题，仍有许多尚未解答。本文质疑了最佳过渡计划的定义和组成部分、其有效性和成本。很少有过渡计划得到了全面评估，而有效性研究通常基于历史对照组。本文描述了神经障碍的过渡诊所，但未对其进行评估。糖尿病、肾移植和风湿性疾病的研究提供了目前可获得的过渡诊所/计划价值的最佳证据，但这些证据有限。有几项研究探讨了过渡诊所的成本，并表明诊所的增量成本可通过成人护理中降低的医疗成本得到弥补。关于过渡问题，仍有大量研究空间。
