Abstract
This chapter will provide an overview of the structural aspects and processes that characterize healthcare transition (HCT) models. Comparisons and contrasts between HCT models that focus on the transfer of care and those that are more comprehensive in scope will be reviewed. Outcomes associated with the measurement of HCT service and adolescents and young adults with special healthcare needs will be discussed. Points of emphasis for clinical application are featured in the chapter tables and case example.
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References
Magrab PR, Miller HEC, editors. Surgeon's General’s Conference: growing up and getting medical care: youth with special health care needs. A summary of conference proceedings. 1989 March 13–15. Jekyll Island, Georgia: National Center for Networking Community Based Services. Georgetown University Child Development Center; 1989.
Betz CL. Transition of adolescents with special health care needs: review and analysis of the literature. Issues Compr Pediatr Nurs. 2004;27:179–240.
Betz CL, O'Kane LS, Nehring WM, Lobo ML. Systematic review: health care transition practice service models. Nurs Outlook 2016;64(3):229–243. PubMed
Chu PY, Maslow GR, von Isenburg M, Chung RJ. Systematic review of the impact of transition interventions for adolescents with chronic illness on transfer from pediatric to adult healthcare. J Pediatr Nurs. 2015;30(5):e19–e27. PubMed Pubmed Central PMCID: NIHMS710745.
Bloom SR, Kuhlthau K, Van Cleave J, Knapp AA, Newacheck P, Perrin JM. Health care transition for youth with special health care needs. J Adolesc Health 2012;51(3):213–219. PubMed English.
Coyne B, Hallowell SC, Thompson M. Measurable outcomes after transfer from pediatric to adult providers in youth with chronic illness. J Adolesc Health 2017;60(1):3–16. PubMed
Binks JA, Barden WS, Burke TA, Young NL. What do we really know about the transition to adult-centered health care? A focus on cerebral palsy and spina bifida. Arch Phys Med Rehabil. 2007;88(8):1064–73.
American Academy of Pediatrics American Academy of Family Practice, & American College of Physicians-American Society of Internal Medicine. A consensus statement on health care transitions for young adults with special health care needs. Pediatrics. 2002;110(6 Pt 2):1304–6.
American Academy of Pediatrics, American Academy of Family Practice, American College of Physicians, Transitions Clinical Report Authoring G, Cooley WC, Sagerman PJ Supporting the health care transition from adolescence to adulthood in the medical home. Pediatrics 2011;128(1):182–200. PubMed
Society of Pediatric Nurses. SPN position statement: transition of pediatric patients into adult care. Chicago, Illinois: Society of Pediatric Nurses; 2016. p. 9.
Ludvigsson JF, Agreus L, Ciacci C, Crowe SE, Geller MG, Green PH, et al. Transition from childhood to adulthood in coeliac disease: the Prague consensus report. Gut 2016;65(8):1242–1251. PubMed
Suris JC, Akre C. Key elements for, and indicators of, a successful transition: an international Delphi study. J Adolesc Health 2015;56(6):612–618. PubMed
Rosen DS, Blum RW, Britto M, Sawyer SM, Siegel DM. Transition to adult health care for adolescents and young adults with chronic conditions. J Adolesc Health. 2003;33(4):309–11.
Baldassano R, Ferry G, Griffiths A, Mack D, Markowitz J, Winter H. Transition of the patient with inflammatory bowel disease from pediatric to adult care: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2002;34(3):245–8.
Geerlings RP, Aldenkamp AP, de With PH, Zinger S, Gottmer-Welschen LM, de Louw AJ. Transition to adult medical care for adolescents with epilepsy. Epilepsy Behav 2015;44:127–135. PubMed
McManus M, White P, Pirtle R, Hancock C, Ablan M, Corona-Parra R. Incorporating the six core elements of health care transition into a medicaid managed care plan: lessons learned from a pilot project. J Pediatr Nurs. 2015;30(5):700–13.
Betz CL, Smith KA, Van Speybroeck A, Hernandez FV, Jacobs RA. Movin’ on up: an innovative nurse-led interdisciplinary health care transition program. J Pediatr Health Care 2016;30(4):323–338. PubMed
Bridgett M, Abrahamson G, Ho J. Transition, it's more than just an event: supporting young people with type 1 diabetes. J Pediatr Nurs. 2015;30(5):e11–e4.
Ciccarelli MR, Gladstone EB, Armstrong Richardson EAJ. Implementation of a transdisciplinary team for the transition support of medically and socially complex youth. J Pediatr Nurs. 2015;30(5):661–7.
Woodward JF, Swigonski NL, Ciccarelli MR. Assessing the health, functional characteristics, and health needs of youth attending a noncategorical transition support program. J Adolesc Health 2012;51(3):272–278. PubMed English.
McDonagh JE, Shaw KL, Southwood TR. Growing up and moving on in rheumatology: development and preliminary evaluation of a transitional care programme for a multicentre cohort of adolescents with juvenile idiopathic arthritis. J Child Health Care 2006;10(1):22–42. .PubMed English.
Dabadie A, Troadec F, Heresbach D, Siproudhis L, Pagenault M, Bretagne JF. Transition of patients with inflammatory bowel disease from pediatric to adult care. Gastroenterol Clin Biol. 2008;32(5 Pt 1):451–9.
Vanelli M, Caronna S, Adinolfi B, Chiari G, Gugliotta M, Arsenio L. Effectiveness of an uninterrupted procedure to transfer adolescents with Type 1 diabetes from the paediatric to the adult clinic held in the same hospital: eight-year experience with the parma protocol. Diabetes Nutr Metab 2004;17(5):304–308. PubMed
Bhawra J, Toulany A, Cohen E, Moore Hepburn C, Guttmann A. Primary care interventions to improve transition of youth with chronic health conditions from paediatric to adult healthcare: a systematic review. BMJ Open 2016;6(5):e011871. PubMed
Bollegala N, Nguyen GC. Transitioning the adolescent with IBD from pediatric to adult care: a review of the literature. Gastroenterology Research & Practice 2015;2015:853530. PubMed
Embrett MG, Randall GE, Longo CJ, Nguyen T, Mulvale G. Effectiveness of health system services and programs for youth to adult transitions in mental health care: a systematic review of academic literature. Adm Policy Ment Health 2016;43(2):259–269. PubMed
Peter NG, Forke CM, Ginsburg KR, Schwarz DF. Transition from pediatric to adult care: internists' perspectives. Pediatrics. 2009;123(2):417–23.
DiIorio C, Shafer PO, Letz R, Henry TR, Schomer DL, Yeager K. Behavioral, social, and affective factors associated with self-efficacy for self-management among people with epilepsy. Epilepsy Behav. 2006;9(1):158–63.
DiIorio C, Osborne Shafer P, Letz R, Henry T, Schomer DL, Yeager K. The association of stigma with self-management and perceptions of health care among adults with epilepsy. Epilepsy Behav. 2003;4(3):259–67.
Sawin KJ, Brei T, Holmbeck G. The development of the adolescent\young adult self-management and independence scale-AMIS II: psychometric data. 2017.
Sawin, KJ, Bellin, M, Woodward, J,Brei, T. Self-management in spina bifida: a synthesis in literature. Paper presented at the Third World Congress on Spina Bifida Research and Care; 2017 March 16–19; San Diego, CA
Holmes-Walker DJ, Llewellyn AC, Farrell KA. transition care programme which improves diabetes control and reduces hospital admission rates in young adults with Type 1 diabetes aged 15–25 years. Diabet Med. 2007;24(7):764–9.
Smith GM, Lewis VR, Whitworth E, Gold DT, Thornburg CD. Growing up with sickle cell disease: a pilot study of a transition program for adolescents with sickle cell disease. J Pediatr Hematol Oncol 2011;33(5):379–382. PubMed
Wiener LS, Kohrt B, Battles HB, Pao M. The HIV experience: youth identified barriers for transitioning from pediatric to adult care. J Pediatr Psychol. 2011;36(2):141–54.
Betz CL, Lobo ML, Nehring WM, Bui K. Voices not heard: a systematic review of adolescents' and emerging adults’ perspectives of health care transition. Nurs Outlook 2013;61(5):311–336. PubMed
Betz CL, Nehring WM, Lobo ML. Transition needs of parents of adolescents and emerging adults with special health care needs and disabilities. J Fam Nurs 2015;21(3):362–412. PubMed
Agency for Healthcare Quality and Research. Care Coordination Rockville, MD: Agency for Healthcare Research and Quality. 2016 [updated July 2016; cited 15 October 2017]. http://www.ahrq.gov/professionals/prevention-chronic-care/improve/coordination/index.html.
Blomquist K, Brown G, Peersen A, Presler E. Transitioning to independence: challenges for young people with disabilities and their caregivers. Orthop Nurs. 1998;17(3):27–35.
Blomquist KB. Healthy and ready to work: Kentucky: incorporating transition into a state program for children with special health care needs. Pediatr Nurs 2006;32(6):515–528. PubMed
Lerret SM, Menendez J, Weckwerth J, Lokar J, Mitchell J, Alonso EM. Essential components of transition to adult transplant services: the transplant coordinators' perspective. Prog Transplant 2012;22(3):252–258. PubMed
Rogers K, Zeni MB. Systematic review of medical home models to promote transitions to primary adult health care for adolescents living with autism spectrum disorder. Worldviews Evid Based Nurs 2015;12(2):98–107. PubMed
Annunziato RA, Baisley MC, Arrato N, Barton C, Henderling F, Arnon R, et al. Strangers headed to a strange land? A pilot study of using a transition coordinator to improve transfer from pediatric to adult services. J Pediatr 2013;163(6):1628–1633. PubMed
Betz CL, Redcay G. Dimensions of the transition service coordinator role. J Soc Pediatr Nurs 2005;10(2):49–59. PubMed
Jivanjee P, Kruzich J. Supports for young people with mental health conditions and their families in the transition years: youth and family voices. Best Prac Ment Health. 2011;7:115–33.
Jivanjee P, Kruzich JM, Gordon LJ. The age of uncertainty: parent perspectives on the transition of young people with mental health difficulties to adulthood. J Child Fam Stud. 2009;18:435–46.
Kieckhefer GM, Trahms CM, Churchill SS, Simpson JN. Measuring parent-child shared management of chronic illness. Pediatr Nurs. 2009;35(2):101–8.
Kieckhefer GM, Trahms CM. Supporting development of children with chronic conditions: from compliance toward shared management. Pediatr Nurs 2000;26(4):354–363. PubMed
Stinson JN, Toomey PC, Stevens BJ, Kagan S, Duffy CM, Huber A, et al. Asking the experts: exploring the self-management needs of adolescents with arthritis.[see comment]. Arthritis Rheum. 2008;59(1):65–72.
Heath G, Farre A, Shaw K. Parenting a child with chronic illness as they transition into adulthood: a systematic review and thematic synthesis of parents’ experiences. Patient Educ Couns 2017;100(1):76–92. PubMed
Andreoni KA, Forbes R, Andreoni RM, Phillips G, Stewart H, Ferris M. Age-related kidney transplant outcomes: health disparities amplified in adolescence. JAMA Intern Med 2013;173(16):1524–1532. PubMed English.
Allen D, Channon S, Lowes L, Atwell C, Lane C. Behind the scenes: the changing roles of parents in the transition from child to adult diabetes service. Diabet Med 2011;28(8):994–1000. PubMed
Hess JS, Straub DM. Brief report: preliminary findings from a pilot health care transition education intervention for adolescents and young adults with special health care needs. J Pediatr Psychol 2010;36(2):172–178. PubMed
Scott L, Vallis M, Charette M, Murray A, Latta R. Transition of care: researching the needs of young adults with type 1 diabetes. Can J Diabetes. 2005;29:203–10.
Betz CL, Ferris ME, Woodward JF, Okumura MJ, Jan S, Wood DL. The health care transition research consortium health care transition model: a framework for research and practice. J Pediatr Rehabil Med 2014;7(1):3–15. PubMed
Ihara ES, Wolf-Branigin M, White P. Quality of life and life skill baseline measures of urban adolescents with disabilities. Soc Work Public Health 2012;27(7):658–670. PubMed English.
Yorkery B, Test DW. Improving educational outcomes and post-school success for students with disabilities. N C Med J 2009;70(6):542–544. PubMed
Rosen D. Between two worlds: bridging the cultures of child health and adult medicine. J Adolesc Health 1995;17(1):10–16. PubMed
Okumura MJ, Heisler M, Davis MM, Cabana MD, Demonner S, Kerr EA. Comfort of general internists and general pediatricians in providing care for young adults with chronic illnesses of childhood. J Gen Intern Med 2008;23(10):1621–1627. PubMed
Nehring WM, Betz CL, Lobo ML. Uncharted territory: systematic review of providers' roles, understanding, and views pertaining to health care transition. J Pediatr Nurs 2015;30(5):732–747. PubMed
Arnett JJ. Emerging adulthood. a theory of development from the late teens through the twenties. Am Psychol. 2000;55(5):469–80.
Arnett JJ, Tanner JL. Emerging adults in America. Coming of age in the 21st century. American Psychological Association: Washington, D.C; 2006.
Camfield P, Camfield C, Pohlmann-Eden B. Transition from pediatric to adult epilepsy care: a difficult process marked by medical and social crisis. Epilepsy Currents 2012;12(Suppl 3):13–21. PubMed
Cadario F, Prodam F, Bellone S, Trada M, Binotti M, Trada M, et al. Transition process of patients with type 1 diabetes (T1DM) from paediatric to the adult health care service: a hospital-based approach. Clin Endocrinol (Oxf) 2009;71(3):346–350. PubMed
Jurasek L, Ray L, Quigley D. Development and implementation of an adolescent epilepsy transition clinic. J Neurosci Nurs 2010;42(4):181–189. PubMed
Pyatak EA, Carandang K, Vigen C, Blanchard J, Sequeira PA, Wood JR, et al. Resilient, Empowered, Active Living with Diabetes (REAL Diabetes) study: methodology and baseline characteristics of a randomized controlled trial evaluating an occupation-based diabetes management intervention for young adults. Contemp Clin Trials 2017;54:8–17. PubMed
Wafa S, Nakhla M. Improving the transition from pediatric to adult diabetes healthcare: a literature review. Can J Diabetes 2015;39(6):520–528. PubMed
Hazel E, Zhang X, Duffy CM, Campillo S. High rates of unsuccessful transfer to adult care among young adults with juvenile idiopathic arthritis. Pediatr Dent 2010;8:2. PubMed
Steinbeck KS, Shrewsbury VA, Harvey V, Mikler K, Donaghue KC, Craig ME, et al. A pilot randomized controlled trial of a post-discharge program to support emerging adults with type 1 diabetes mellitus transition from pediatric to adult care. Pediatr Diabetes 2015;16(8):634–639. PubMed
Betz CL, Smith K. Measuring health care transition planning outcomes: challenges and issues. Int J Child Adolesc Health. 2010;3:463–72.
Le Roux E, Mellerio H, Guilmin-Crepon S, Gottot S, Jacquin P, Boulkedid R, et al. Methodology used in comparative studies assessing programmes of transition from paediatrics to adult care programmes: a systematic review. BMJ Open 2017;7(1):e012338. PubMed
Kipps S, Bahu T, Ong K, Ackland FM, Brown RS, Fox CT, et al. Current methods of transfer of young people with Type 1 diabetes to adult services. Diabet Med. 2002;19(8):649–54.
Gleeson H, Turner G. Transition to adult services. Arch Dis Child Educ Pract Ed 2012;97(3):86–92. PubMed English.
Bolton-Maggs PH. Transition of care from paediatric to adult services in haematology. Arch Dis Child. 2007;92(9):797–801.
Harden PN, Walsh G, Bandler N, Bradley S, Lonsdale D, Taylor J, et al. Bridging the gap: an integrated paediatric to adult clinical service for young adults with kidney failure. BMJ 2012;344:e3718. PubMed English.
Watson AR. Non-compliance and transfer from paediatric to adult transplant unit. Pediatr Nephrol. 2000;14(6):469–72.
Shaw KL, Southwood TR, McDonagh JE, British Society of Paediatric and Adolescent Rheumatology. Development and preliminary validation of the ‘Mind the Gap’ scale to assess satisfaction with transitional health care among adolescents with juvenile idiopathic arthritis. Child Care Health Dev. 2007;33(4):380–8.
Shaw KL, Southwood TR, McDonagh JE, British Society of Paediatric and Adolescent Rheumatology. Young people's satisfaction of transitional care in adolescent rheumatology in the UK. Child Care Health Dev. 2007;33(4):368–79.
Reid GJ, Irvine MJ, McCrindle BW, Sananes R, Ritvo PG, Siu SC, et al. Prevalence and correlates of successful transfer from pediatric to adult health care among a cohort of young adults with complex congenital heart defects. Pediatrics. 2004;113(3 Pt 1):e197–205.
Betz CL, Redcay G. An exploratory study of future plans and extracurricular activities of transition-age youth and young adults. Issues Compr Pediatr Nurs. 2005;28(1):33–61.
Di Rezze B, Nguyen T, Mulvale G, Barr NG, Longo CJ, Randall GE. A scoping review of evaluated interventions addressing developmental transitions for youth with mental health disorders. Child Care Health Dev 2016;42(2):176–187. PubMed
Prior M, McManus M, White P, Davidson L. Measuring the “triple aim” in transition care: a systematic review. Pediatrics 2014;134(6):e1648–e1661. PubMed
Institute for Healthcare Improvement (IHI). IHI triple aim initiative. Better care for individuals, better health for populations, and lower per capita costs (n.d.) [cited 2017 April 15]. http://www.ihi.org/engage/initiatives/TripleAim/Pages/default.aspx.
Sheehan AM, While AE, Coyne I The experiences and impact of transition from child to adult healthcare services for young people with Type 1 diabetes: a systematic review. Diabet Med 2015;32(4):440–458. PubMed
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Betz, C.L. (2018). Different Healthcare Transition Models. In: Hergenroeder, A., Wiemann, C. (eds) Health Care Transition. Springer, Cham. https://doi.org/10.1007/978-3-319-72868-1_36
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