Pediatric to adult care Co-location transitional model for youth with sickle cell disease.
Pediatric to adult care Co-location transitional model for youth with sickle cell disease.
- 2018
Among youth with sickle cell disease (SCD), morbidity and mortality substantially increase following departure from pediatric care. The purpose of this study was to investigate the efficacy of co-location transitional model by comparing the rate of health care utilization pre- and post-transfer to adult care and to evaluate the relation between disease specific knowledge and the co-location model. All patients transferring from pediatric to adult care between October 2011 and December 2013, opting for the co-location model to transition from pediatric to adult care in Memphis, TN were included in the analysis. Overall utilization, comprised of both acute care visits and hospitalizations, and health-maintenance visits were compared pre- and post-transfer. Additionally, the association between patient understanding of pain and all health care utilization were assessed. There were 59 participants who established adult care using the co-location transitional model. We found an increase in acute care visits, but a decrease in hospitalizations, that resulted in no change in overall utilization (IRR: 1.11; (95%CI: 0.76, 1.63) comparing pediatric to adult care. The overall utilization rate during adult care was below those previously reported (3.61 vs. 1.65 per person-year, p<0.001). Additionally, we found a significant decrease in hospitalizations and an increase in health-maintenance visits associated with higher pain knowledge after transfer. The co-location model for pediatric to adult care transition seems to provide benefits among youth with SCD by increasing disease knowledge and reducing health care utilization to levels below those seen at the national level. This article is protected by copyright. All rights reserved. Copyright (c) 2017 Wiley Periodicals, Inc.
English
0361-8609
*Anemia, Sickle Cell/th [Therapy]
*Transition to Adult Care
Adult
Child
Humans
Patient Transfer
MedStar Health Research Institute
Letter
Among youth with sickle cell disease (SCD), morbidity and mortality substantially increase following departure from pediatric care. The purpose of this study was to investigate the efficacy of co-location transitional model by comparing the rate of health care utilization pre- and post-transfer to adult care and to evaluate the relation between disease specific knowledge and the co-location model. All patients transferring from pediatric to adult care between October 2011 and December 2013, opting for the co-location model to transition from pediatric to adult care in Memphis, TN were included in the analysis. Overall utilization, comprised of both acute care visits and hospitalizations, and health-maintenance visits were compared pre- and post-transfer. Additionally, the association between patient understanding of pain and all health care utilization were assessed. There were 59 participants who established adult care using the co-location transitional model. We found an increase in acute care visits, but a decrease in hospitalizations, that resulted in no change in overall utilization (IRR: 1.11; (95%CI: 0.76, 1.63) comparing pediatric to adult care. The overall utilization rate during adult care was below those previously reported (3.61 vs. 1.65 per person-year, p<0.001). Additionally, we found a significant decrease in hospitalizations and an increase in health-maintenance visits associated with higher pain knowledge after transfer. The co-location model for pediatric to adult care transition seems to provide benefits among youth with SCD by increasing disease knowledge and reducing health care utilization to levels below those seen at the national level. This article is protected by copyright. All rights reserved. Copyright (c) 2017 Wiley Periodicals, Inc.
English
0361-8609
*Anemia, Sickle Cell/th [Therapy]
*Transition to Adult Care
Adult
Child
Humans
Patient Transfer
MedStar Health Research Institute
Letter