Young adults in children's hospitals: why are they there?
OBJECTIVE
To measure the pattern of admissions of young adults to a children's hospital.


METHODS
Ten-year audit (1992-2001) of admissions of young adults aged 18 years and over to the Royal Children's Hospital (RCH), Melbourne, with a detailed chart review of the 2001 cohort to assess disease complexity and transition planning.


METHODS
Number of admissions, disease complexity, transition planning.


RESULTS
There was a significant increase in the number of young adults admitted over 10 years, from 308 in 1992-1993 to 659 in 2000-2001. The greatest increase was in admissions to surgical units. There was significant variation in admission practices between units over time. Many young adults required multidisciplinary care: 57% had more than three medical/surgical units involved in their care, and 34% had two or more allied health units involved. Fifty-one per cent of surgical inpatients and 28% of medical inpatients had no documented plan for transition to adult care. Only 30% of medical and 17% of surgical inpatients in 2001 had been transferred to adult services by 2002.


CONCLUSIONS
Both disease complexity and failure of transition planning appear to have contributed to the increased admission of young adults to the RCH. While greater support of transition planning is needed, there are also concerns about the lack of appropriate services within the adult sector for young adults with complex, multidisciplinary healthcare needs.
Lam
Pei-Yoong
PY
Centre for Adolescent Health, Royal Children's Hospital, Parkville, VIC, Australia.
Fitzgerald
Bronwyn B
BB
Sawyer
Susan M
SM
D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D000328:Adult; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D015331:Cohort Studies; D006300:Health Services Misuse / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D008485:Medical Audit / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data*; D010347:Patient Care Planning / Q000706:statistics & numerical data; D010360:Patient Transfer / Q000706:statistics & numerical data*; D014600:Utilization Review / Q000706:statistics & numerical data; D014739:Victoria