Preparing for adulthood: health care transition counseling for youth with arthritis.
OBJECTIVE
To determine the proportion of adolescents with arthritis who receive health care transition services and to compare the rates with those reported for adolescents with other special health care needs and adolescents with diabetes.


METHODS
We used data from the 2005-2006 National Survey of Children with Special Health Care Needs. A parent/guardian identified youth ages 12-17 years with arthritis (n = 1,052), diabetes (n = 389), and special health care needs (n = 18,189). Four questions examined the extent to which providers discussed health care transition issues, including 1) transfer of care to adult providers, 2) health care needs of adults, 3) acquiring health insurance, and 4) encouraging self-care responsibility. Bivariate comparisons assessed the associations between sociodemographic characteristics and health care transition services, and multivariate regression models compared outcomes between conditions.


RESULTS
Many adolescents with arthritis are being encouraged to assume self-care responsibilities (74.8%); fewer discussed how health needs will change in adulthood (52.1%), acquiring insurance (22.5%), or transferring care to a provider who sees adults (19.0%). These results are similar to youth with other special health care needs, but behind youth with diabetes.


CONCLUSIONS
Among this sample of US adolescents, many report discussions about health care needs and self-management, but few are addressing critical aspects of the transition to adult-oriented health care.
Scal
Peter
P
University of Minnesota, Minneapolis, USA. scal0005@umn.edu
Horvath
Keith
K
Garwick
Ann
A
D000293:Adolescent; D001171:Arthritis, Juvenile / Q000628:therapy*; D002648:Child; D003266:Continuity of Patient Care; D037001:Directive Counseling; D005260:Female; D006282:Health Personnel; D006301:Health Services Needs and Demand; D006306:Health Surveys; D006801:Humans; D007348:Insurance, Health; D008297:Male; D015999:Multivariate Analysis; D009309:National Center for Health Statistics, U.S.; D011785:Quality Assurance, Health Care; D012044:Regression Analysis; D014481:United States