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自闭症青少年转至成人护理后的儿科护理延续 儿科和成人护理的重叠

Continuation of Pediatric Care after Transfer to Adult Care Among Autistic Youth Overlap of Pediatric and Adult Care.

作者信息

Sirrianni Joseph, Hanks Christopher, Rust Steve, Hart Laura C

机构信息

Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.

The Ohio State University College of Medicine, Columbus, OH, USA.

出版信息

J Autism Dev Disord. 2025 Apr;55(4):1203-1214. doi: 10.1007/s10803-024-06314-5. Epub 2024 Mar 23.

Abstract

The transition from pediatric to adult health care is a vulnerable time period for autistic adolescents and young adults (AYA) and for some autistic AYA may include a period of receiving care in both the pediatric and adult health systems. We sought to assess the proportion of autistic AYA who continued to use pediatric health services after their first adult primary care appointment and to identify factors associated with continued pediatric contact. We analyzed electronic medical record (EMR) data from a cohort of autistic AYA seen in a primary-care-based program for autistic people. Using logistic and linear regression, we assessed the relationship between eight patient characteristics and (1) the odds of a patient having ANY pediatric visits after their first adult appointment and (2) the number of pediatric visits among those with at least one pediatric visit. The cohort included 230 autistic AYA, who were mostly white (68%), mostly male (82%), with a mean age of 19.4 years at the time of their last pediatric visit before entering adult care. The majority (n = 149; 65%) had pediatric contact after the first adult visit. Younger age at the time of the first adult visit and more pediatric visits prior to the first adult visit were associated with continued pediatric contact. In this cohort of autistic AYA, most patients had contact with the pediatric system after their first adult primary care appointment.

摘要

从儿科医疗向成人医疗的过渡,对于患有自闭症的青少年和青年(AYA)来说是一个脆弱的时期,对于一些患有自闭症的AYA而言,这可能包括在儿科和成人医疗系统中都接受治疗的阶段。我们试图评估在首次进行成人初级保健预约后仍继续使用儿科医疗服务的自闭症AYA的比例,并确定与持续与儿科保持联系相关的因素。我们分析了一个针对自闭症患者的初级保健项目中一组自闭症AYA的电子病历(EMR)数据。通过逻辑回归和线性回归,我们评估了八个患者特征与以下两方面的关系:(1)患者在首次成人预约后进行任何儿科就诊的几率;(2)在至少进行过一次儿科就诊的患者中,儿科就诊的次数。该队列包括230名自闭症AYA,他们大多是白人(68%),大多为男性(82%),在进入成人护理前最后一次儿科就诊时的平均年龄为19.4岁。大多数人(n = 149;65%)在首次成人就诊后仍与儿科保持联系。首次成人就诊时年龄较小以及在首次成人就诊前进行过更多次儿科就诊与持续与儿科保持联系有关。在这个自闭症AYA队列中,大多数患者在首次进行成人初级保健预约后仍与儿科系统保持联系。

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