A key topic nowadays at most major national pediatric meetings is “transition” of care. Being able to successfully extend the duration and quality of life of a child with a complex chronic illness into adulthood is a triumph of the pediatric inroads we describe monthly in our journal as do our fellow editors in other journals. But just how good are our systems for transferring care to an adult clinician? Rachas et al. (10.1542/peds.2016-0256) share with us the results of their systematic review trying to identify the outcomes used to measure care continuity.
The authors find 23 studies of which only one was a randomized trial and many focused on diabetes. That being said, a number of indicators are identified that can be helpful in looking at engagement and retention in the transfer and maintenance of continuity of care. Sadly, the heterogeneity of the studies as well as the many that were just observational indicate we have a long way to go in defining good evaluative indicators of successful transition programs for our patients. Without those measures, we may never really know if our patients are going to continue to get the medical home model of care we have given them into their young adulthood.
How smooth are your transitions of care for your older patients with chronic illness? How do you know the transfer went well? We would love to hear your thoughts about this topic or study by responding to this blog, sharing a comment on our website or posting your ideas on our Facebook or Twitter pages.
