Article

Transition of care from pediatric to adult health care providers for
youth with special needs (including cerebral palsy [CP]) is of current interest
because these individuals are now living well into adulthood. Studies have
attempted to identify barriers to transition, ideal timing for transition of
care, and key elements for successful transition programs. These studies often
encompass a wide range of diagnoses, and results cannot be fully applied to those with CP. OBJECTIVE: To identify and describe current transition-of-care (TOC)
practices and beliefs among physician providers of adolescents with CP in
multidisciplinary CP clinics. DESIGN: Descriptive survey. SETTING:
Multidisciplinary CP clinics in the United States. PARTICIPANTS: Physician
leaders in the aforementioned CP clinics. METHODS: Respondents completed an
electronic survey. Responses were deidentified and reported in aggregate by the
use of descriptive statistics. MAIN OUTCOME MEASURE: Electronic survey addressing
3 domains: demographics of clinics, current opinions/practices related to TOC
processes, and perceived barriers to successful TOC. RESULTS: Fifteen surveys
were sent with 11 returned (response rate = 73%). TOC practices varied among
clinics surveyed. Fifty-five percent of clinics had a structured transition
program, but only one transitioned 100% of their patients to adult providers by
22 years of age. Only one clinic had an absolute upper age limit for seeing
patients, and 36% of clinics accepted new patients older than 21 years. No
respondent was "completely satisfied" with their transition process, and only one
respondent was "moderately satisfied." The majority of respondents felt the ideal
care setting for adults with CP was a comprehensive, multidisciplinary
adult-focused clinic in an adult hospital/clinic with primarily adult providers.
They noted the top 3 perceived barriers to successful TOC were limited adult
providers willing to accept CP patients, concern about the level of care in the
adult health care system, and lack of financial resources. CONCLUSION: Current
TOC practices vary considerably among multidisciplinary pediatric CP clinics and
are not satisfactory to individual physician providers within these clinics.
Respondents desired a multidisciplinary clinic in an adult care setting with
adult providers; however, the top 3 perceived barriers involved the adult health
care system, making it difficult for pediatric providers to develop effective TOC
programs. LEVEL OF EVIDENCE: Not applicable.
CI - Copyright (c) 2017 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS