Healthcare Transition from the Adult Provider’s Perspective

  • Nathan Samras
  • Janet Ma
  • Stacey Weinstein
  • Alice A. Kuo


From the adult provider perspective, there are barriers to maintaining high-quality care during the transition of adolescents and young adults with special health-care needs (AYASHCN) from the pediatric provider to the adult provider. There is an insufficient quantity of adult providers prepared to care for this population, and the psychosocial needs of AYASHCN require a special subset of skills from the adult provider. There are unique expectations for the specifics of care from the patient and the family based on years within the pediatric environment. There are health-care structural and insurance issues that may complicate the transition process. Fortunately there are models that the adult provider can use to facilitate successful transition which emphasize coordinated, multidisciplinary, and patient-centered care with understanding of the unique needs of this patient population.


Transition Barriers Internist Young adults Care coordination Patient-centered 


  1. 1.
    American Academy of Pediatrics. Supporting the health care transition from adolescence to adulthood in the medical home. Pediatrics. 2011;128(1):182–200.CrossRefGoogle Scholar
  2. 2.
    American College Health Association National College Health Assessment Reference Group Data Assessment Fall. 2009. Accessed 27 Oct 2017.
  3. 3.
    American Academy of Pediatrics, American Academy of Family Physicians, 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.Google Scholar
  4. 4.
    U.S. Census Bureau, Current population survey, 2013.Google Scholar
  5. 5.
    Blum RW. Overview of transition issues for youth with disabilities. Paediatrician. 1991;18:101–4.Google Scholar
  6. 6.
    National Survey of Children’s Health. Child and adolescent health measurement initiative. Accessed 27 Oct 2017.
  7. 7.
    Sakakibara H. Transition of women with turner syndrome from pediatrics to adult health care: current situation and associated problems. Front Pediatr. 2017;5:28.PubMedPubMedCentralCrossRefGoogle Scholar
  8. 8.
    Youth with Special Health Care Needs Receive the Services Necessary to Make Transitions to Adult Health Care. NS-CSHCN CHARTBOOK 2009-2010. Illustrated Findings from the National Survey of Children with Special Health Care Needs. Accessed 27 Oct 2017.
  9. 9.
    Gravholt CH, et al. Clinical practice guidelines for the care of girls and women with turner syndrome: proceedings from the 2016 Cincinnati international turner syndrome meeting. Eur J Endocrinol. 2017;177(3):G1–G70.PubMedCrossRefGoogle Scholar
  10. 10.
    Sebastian S, et al. The requirements and barriers to successful transition of adolescents with inflammatory bowel disease: differing perceptions from a survey of adult and paediatric gastroenterologists. J Crohn’s Colitis. 2012;6(8):830–44.CrossRefGoogle Scholar
  11. 11.
    Hait EJ, et al. Transition of adolescents with inflammatory bowel disease from pediatric to adult care: a survey of adult gastroenterologists. J Pediatr Gastroenterol Nutr. 2009;48(1):61–5.PubMedCrossRefGoogle Scholar
  12. 12.
    Okumura MJ, et al. 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):1621–7.PubMedPubMedCentralCrossRefGoogle Scholar
  13. 13.
    Trivedi I, Keefer L. The emerging adult with inflammatory bowel disease: challenges and recommendations for the adult gastroenterologist. Gastroenterol Res Pract. 2015;2015:260807.PubMedPubMedCentralCrossRefGoogle Scholar
  14. 14.
    Peter NG, et al. Transition from pediatric to adult care: internists' perspectives. Pediatrics. 2009;123(2):417–23.PubMedPubMedCentralCrossRefGoogle Scholar
  15. 15.
    Pilapil M, et al. Care of adults with chronic childhood conditions: a practical guide. Alexandria, VA: Society of General Internal Medicine; 2016.CrossRefGoogle Scholar
  16. 16.
    United States Census Bureau. Age and sex composition: 2010. 2010 census briefs. Accessed 27 Oct 2017.
  17. 17.
    The Complexities of Physician Supply and Demand: Projections from 2014 to 2025. Association of American Medical Colleges. Accessed 27 Oct 2017.
  18. 18.
    McLaren S, et al. ‘Talking a different language’: an exploration of the influence of organizational cultures and working practices on transition from child to adult mental health services. BMC Health Serv Res. 2013;13:254–64.PubMedPubMedCentralCrossRefGoogle Scholar
  19. 19.
    Arnett JJ. Emerging adulthood. A theory of development from the late teens through the twenties. Am Psychol. 2000;55(5):469–80.PubMedPubMedCentralCrossRefGoogle Scholar
  20. 20.
    U.S. Census Bureau. Current population survey. 1999. Accessed 27 Oct 2017.
  21. 21.
    Park MJ, et al. The health status of young adults in the United States. J Adolesc Health. 2006;39(3):305–17.PubMedCrossRefGoogle Scholar
  22. 22.
    Institute of Medicine and National Research Council. Investing in the health and well-being of young adults. Washington, DC: The National Academies Press; 2015.Google Scholar
  23. 23.
    Center for Disease Control. Health, United States, 2015, with special feature on racial and ethnic health disparities. Accessed 27 Oct 2017.
  24. 24.
    Halfon N, et al. The handbook of life course health development science. New York, NY: Springer International Publishing; 2017.Google Scholar
  25. 25.
    Dummer TJ, et al. Targeting policy for obesity prevention: identifying the critical age for weight gain in women. J Obes. 2012;2012:934895.PubMedPubMedCentralCrossRefGoogle Scholar
  26. 26.
    Hingson RW, et al. Age at drinking onset and alcohol dependence: age at onset, duration, and severity. Arch Pediatr Adolesc Med. 2006;160(7):739–46.PubMedCrossRefGoogle Scholar
  27. 27.
    Hunt S, Sharma N. Pediatric to adult-care transitions in childhood-onset chronic disease: hospitalist perspectives. J Hosp Med. 2013;8(11):627–30.PubMedCrossRefGoogle Scholar
  28. 28.
    Bloom SR, et al. Health care transition for youth with special health care needs. J Adolesc Health. 2012;51:213–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Sonneveld HM, et al. Gaps in transitional care: what are the perceptions of adolescents, parents and providers? Child Care Health Dev. 2012;39:69–80.PubMedCrossRefGoogle Scholar
  30. 30.
    Defining the Patient Centered Medical Home, U.S. Department of Health & Human Services. Accessed 27 Oct 2017.
  31. 31.
    Ferrante JM, et al. Principles of the patient-centered medical home and preventive services delivery. Ann Fam Med. 2010;8(2):108–16.PubMedPubMedCentralCrossRefGoogle Scholar
  32. 32.
    World Health Organization. Innovative care for chronic conditions, building blocks for action. Accessed 27 Oct 2017.
  33. 33.
    Goldenring JM, Rosen DS. Getting into adolescent heads: an essential update. Contemp Pediatr. 2004;21(1):64–90.Google Scholar
  34. 34.
    U.S. Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings. Accessed 27 Oct 2017.
  35. 35.
    Long SK, et al. The health reform monitoring survey: addressing data gaps to provide timely insights into the affordable care act. Health Aff (Millwood). 2014;33(1):161–7.CrossRefGoogle Scholar
  36. 36.
    Postolowski C, et al. Helping students understand health care reform and enroll in health insurance. 2013. Accessed 27 Oct 2017.
  37. 37.
    Dauner KN, Thompson J. Young adult’s perspectives on being uninsured and implications for health reform. Qual Rep. 2014;19(4):1.Google Scholar
  38. 38.
    Barr VJ, et al. The expanded chronic care model: an integration of concepts and strategies from population health promotion and the chronic care model. Hosp Q. 2003;7(1):73–82.PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Nathan Samras
    • 1
  • Janet Ma
    • 1
  • Stacey Weinstein
    • 1
  • Alice A. Kuo
    • 1
  1. 1.Division of Internal Medicine and PediatricsUCLA Department of MedicineLos AngelesUSA

Personalised recommendations