Addressing transition to adult health care for adolescents with special health care needs.
OBJECTIVE
To determine the factors associated with addressing the transition from pediatric to adult-oriented health care among US adolescents with special health care needs.


METHODS
Data for 4332 adolescents, 14 to 17 years of age, from the 2000-2001 National Survey of Children With Special Health Care Needs were used. The adequacy of transition services was determined by parent self-report. Explanatory variables, including parental education, family poverty status, race/ethnicity, measures of the severity and complexity of conditions, health insurance status, having a personal doctor, and the quality of the parent's relationship with the adolescent's doctor, were entered into a regression model.


RESULTS
Overall, 50.2% of parents reported that they had discussed transition issues with their adolescent's doctor and 16.4% had discussed and developed a plan for addressing those needs. In a multivariate regression analysis, correlates of the adequacy of transition services included older age, female gender, complexity of health care needs, and higher quality of the parent-doctor relationship.


CONCLUSIONS
Among adolescents with special health care needs, those who were older and those with more complicated needs were more likely to have addressed the transition from a pediatric to adult-oriented system of care. Furthermore, this analysis demonstrated a strong association between a high-quality parent-provider relationship and the extent to which transition issues were addressed. The importance of transition services for adolescents with less complex needs and the overall impact of health care transition services were not assessed in this study and remain important questions for future investigations.
Scal
Peter
P
Division of General Pediatrics and Adolescent Health, University of Minnesota Medical School, Minneapolis, Minnesota 55455, USA. scal0005@umn.edu
Ireland
Marjorie
M
D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D000375:Aging; D019090:Case Management; D002908:Chronic Disease / Q000453:epidemiology / Q000628:therapy; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D006301:Health Services Needs and Demand; D006306:Health Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D008297:Male; D010290:Parents / Q000523:psychology*; D011203:Poverty; D011368:Professional-Family Relations; D012494:Sampling Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data