Ross Mindy K, Moscicki Anna-Barbara, Kawai Kosuke, Chen Lucia
Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, Calif.
Department of Medicine, David Geffen School of Medicine, Statistical Core, University of California Los Angeles, Los Angeles, Calif.
J Allergy Clin Immunol Glob. 2024 Oct 30;4(1):100363. doi: 10.1016/j.jacig.2024.100363. eCollection 2025 Feb.
Adolescents and young adults with asthma face increased risks during the health care transition (HCT) from pediatric to adult care. Despite guidelines advocating for more HCT preparedness, this does not consistently occur in clinical practice. The rates of exposure to transition preparation in adolescents with asthma are unknown.
Our goal was to understand the rates of HCT exposure among adolescents with asthma in the United States, along with predictive characteristics associated with receiving HCT exposure, as determined by using data from a nationally representative survey.
We studied adolescents aged 12 to 17 years with asthma in the 2020-2021 National Survey of Children's Health data set. We explored associations between sociodemographic, health-related, and provider practice-related variables and HCT exposure through univariate analysis and multivariable logistic regression.
Only 19% of adolescents with asthma from this cohort met criteria indicating that they had received HCT exposure. In our multivariable analysis, being older, being female, having a provider actively work with the child to make positive choices about health, having a written care plan addressing transition, having routine preventive care visits, and having a caregiver who has someone with whom to discuss health insurance into adulthood were associated with higher odds of HCT exposure. Hispanic ethnicity, lack of insurance, and residence in a metropolitan area were associated with lower odds of receiving preparation for transitional care but were not significant in the multivariable model.
Our findings underscore the need to improve transitional care preparation for adolescents with asthma, with attention needed to address disparities based on sociodemographic factors, including health care access.
患有哮喘的青少年和青年在从儿科护理过渡到成人护理的医疗保健过渡（HCT）期间面临更高的风险。尽管有指南提倡加强HCT准备，但在临床实践中这并不总是能实现。哮喘青少年接受过渡准备的比例尚不清楚。
我们的目标是了解美国哮喘青少年的HCT暴露率，以及通过使用具有全国代表性的调查数据确定的与接受HCT暴露相关的预测特征。
我们研究了2020 - 2021年全国儿童健康调查数据集中12至17岁的哮喘青少年。我们通过单变量分析和多变量逻辑回归探讨了社会人口统计学、健康相关和提供者实践相关变量与HCT暴露之间的关联。
该队列中只有19%的哮喘青少年符合表明他们接受过HCT暴露的标准。在我们的多变量分析中，年龄较大、女性、有提供者积极与孩子合作以做出关于健康的积极选择、有一份涉及过渡的书面护理计划、进行常规预防性护理就诊以及有一位成年后有可与之讨论健康保险事宜的人的照顾者，与更高的HCT暴露几率相关。西班牙裔、缺乏保险以及居住在大都市地区与接受过渡性护理准备的几率较低相关，但在多变量模型中不显著。
我们的研究结果强调需要改善对哮喘青少年的过渡性护理准备，需要关注解决基于社会人口统计学因素的差异，包括医疗保健可及性。
