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Policy does away with age limits in pediatric care :

August 21, 2017

No longer recommending “arbitrary age limits on pediatric health care,” an updated AAP policy statement leaves the decision to individual patients and pediatricians.

Age Limit of Pediatrics,, has evolved since the Academy’s first version was published in 1938. At that time, the statement considered an upper patient age limit to be the patient’s 16th or 18th year of life. Gradually, the policy was expanded to include patients before birth and up to age 21 with exceptions for older children with special health care needs and other considerations.

The latest version leaves the decision to individual patients and pediatricians or pediatric, medical or surgical subspecialists in consideration of the patient’s physical and psychosocial needs. Among the considerations is growing evidence that brain development does not reach adult levels of functioning until well into the third decade of life. Financial and developmental reasons also are noted, and the policy acknowledges the growing number of children with special health care needs surviving into adulthood whose only access to specialized services is through their pediatrician.

The policy advises discussing the transition to an adult care provider well before transition is necessary. It calls for an extension of guidelines such as Bright Futures to cover recommended services for those in their 20s. Likewise, health care insurers and other payers are advised to avoid placing limits that affect the patient’s choice of care solely based on age.

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