Development of Healthcare Transition Policy and Concepts

Abstract

The evolution of healthcare transition (HCT) as a field of practice and research has been measured and, at times, restrained. The ongoing arrival of adolescents and emerging adults into adult health care continues to be unrelenting, creating significant pressures on both the pediatric and adult systems of care. Neither of these systems is well prepared to provide the needed services to this population to effect a smooth uninterrupted transfer from pediatric to adult care and to ensure care is established with the team of adult primary and specialty care providers. This chapter will provide a historical context of the origins of the field of HCT that have influenced its development and current status. Presentation of the national conferences convened and position statements generated in the late 1980s and during the 1990s will be reviewed as to their importance with influencing the direction of the field. Government initiatives that were first enacted in the late 1990s and subsequently in the years to come up to the present will be described as to the provision of needed resources to enable the growth of the field. The investment of federal funding and identification of transition as a priority of care in the Title V Programs for Children with Special Health Care Needs will be explicated. The federal commitment to transition as identified now in Healthy People 2020 is presented as another example of the governmental policy support that has enable this field to move forward. This chapter will conclude with examples of the efforts undertaken more recently by HCT experts to contribute to its emerging body of evidence and development and implementation of practice models.