[Transition clinics in endocrinology and diabetology for the chronically ill in Germany. A recent inquiry].
OBJECTIVE
Transferring adolescent patients with endocrine disorders from paediatric to adult care units depends on regional facilities with varying efficiency. A nationwide system of transition clinics in Germany is actually not available, despite demands by physicians and patients.


METHODS
We conducted a survey for the 36 German university hospitals to examine the regional existence and characteristics of actual transition methods. In a second questionnaire patients were asked to report their individual transition periods.


RESULTS
Despite physician's demand in the majority of hospitals, there are only eight transition clinics nationwide. On average 56 patients attended these clinics yearly. Most patients suffered from disorders of pituitary, thyroid or adrenal gland (each 76 %) and diabetes mellitus type 1 (82 %). The perception of teamwork between the paediatric and adult care units was better in hospitals with transition clinics. Moreover, there was more scientific cooperation in those hospitals. Attendance to medical care and patient's compliance was enhanced by establishing transition clinics in 82 % and 70 %, respectively. Questioning affected patients we found attendance to the paediatric team up to the age of twenty with substantial difficulties finding an adequate adult care unit. Patients were more contend with paediatric than adult quality of physicians care (mark 1.6 versus 2.4). 82 % of patients judged establishing transition clinics as "urgently needed".


CONCLUSIONS
In conclusion there are transition clinics in one quarter of German university hospitals. A more widespread installation of transition clinics is medical reasonable and is demanded by patients.
Lausch
M
M
Abteilung Nephrologie, Medizin IV, Universitätsklinikum Freiburg. lausch@med1.ukl.uni-freiburg.de
Reincke
M
M
D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D003266:Continuity of Patient Care; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology / Q000628:therapy; D004700:Endocrine System Diseases / Q000523:psychology / Q000628:therapy*; D004704:Endocrinology; D005858:Germany; D006785:Hospitals, University; D006801:Humans; D010044:Outpatient Clinics, Hospital; D010349:Patient Compliance; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010360:Patient Transfer / Q000592:standards*; D010372:Pediatrics; D011795:Surveys and Questionnaires