Association of provider scope of practice with successful transition for youth with special health care needs.
OBJECTIVE
Youth with special health care needs (YSHCN) encounter unique challenges in the transition from pediatric to adult healthcare. Although discussing transition with healthcare providers can be beneficial, it is unclear whether the providers' scope of practice (child-only vs. lifespan-oriented) drives these discussions. We examined the association between scope of practice and transition-related services.


METHODS
We used caregivers' responses in the 2005-2006 National Survey of Children with Special Healthcare Needs. We compared transition outcomes for youth whose providers treated only children, and youth whose providers also treated adults (lifespan-oriented). Individual and household-level demographic factors were applied to logistic regression models.


RESULTS
Youth with lifespan-oriented providers were more likely than youth with child-only providers to have discussed changing health needs in adulthood (52% vs. 43%) and adult health insurance (24% vs. 21%). There was no difference in receiving encouragement toward self-responsibility (79% vs. 78%). These associations persisted after adjusting for demographics.


CONCLUSIONS
YSHCN are more likely to report having discussed issues related to transition into adult healthcare if their providers treat adults as well as children. However, discussion involving adult health insurance in particular was lacking for all YSHCN.
Epidemiology Consult Service, United States Air Force School of Aerospace Medicine, 2513 Kennedy Circle, Brooks City-Base, TX 78235, USA. brett.nishikawa@brooks.af.mil
Brett R
BR
Nishikawa
Timothy P
TP
Daaleman
Savithri
S
Nageswaran
D000293:Adolescent; D000328:Adult; D017028:Caregivers; D002648:Child; D002908:Chronic Disease; D003266:Continuity of Patient Care / Q000458:organization & administration* / Q000592:standards; D002658:Developmental Disabilities / Q000628:therapy*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007348:Insurance, Health / Q000592:standards*; D008297:Male; D020380:Needs Assessment / Q000458:organization & administration* / Q000592:standards