This paper examines the healthcare transition process that all youth must undergo as they move from pediatric-oriented to adult-focused medical care. It focuses particularly on adolescents and young adults with special healthcare needs, noting that approximately 10 million children in the United States require specialized care. The paper discusses barriers to effective transition protocols, gaps in medical education at multiple levels, recent federal health policy changes, and the roles of various healthcare providers — including family physicians, pediatricians, and subspecialists — in facilitating seamless transitions. It also emphasizes the importance of family involvement, communication, and transition readiness among healthcare organizations.
All youth must undergo a change from childhood to adulthood in the kind of medical care they receive. This transition process is challenging, particularly for youth with special healthcare needs. Most young adults today do not receive medical care appropriate for their age, and they are at a higher risk of illness because they are especially vulnerable (Sharma et al., 2014). Early research suggests that many barriers prevent effective protocols and transitions, which has slowed improvement in the healthcare process. The outcomes of a successful transition are now more clearly defined, and the education of providers significantly influences how well the transition is carried out.
Moreover, gaps in medical education exist at undergraduate, graduate, and postgraduate levels — a significant obstacle to the transition process (Sharma et al., 2014). Current changes in federal health policy have allowed for improvements in healthcare coverage by providing new financial incentives and testing new structures that promote transitional healthcare, including accountable care organizations. Future work must demonstrate how changes in these systems may impact the quality of care (Mubanga et al., 2017). Transition protocols must be tailored to various medical subspecialties, and healthcare organizations must be prepared with adequate transition readiness.
The transition from childhood to adult-focused care for adolescents with chronic diseases has become increasingly important. A successful transition primarily aims to establish a new adult medical home to support continuity of care for young adults. Approximately 10 million children between the ages of 0 and 17 in the United States are estimated to require special care (Sharma et al., 2014). The number of children with such needs continues to rise with age: 9% of children under six years old have special health needs, and that proportion nearly doubles to 17% among those aged 12 to 17 (Mubanga et al., 2017). Today, 90% of children in the United States survive into adulthood, and 50,000 young people with special healthcare needs — all under the age of 18 — transition annually (Mubanga et al., 2017).
Transitional programs are essential for young adults and adolescents. Adolescents must move from pediatric-oriented care to adult-oriented care, a change that most often occurs during young adulthood and is especially critical for those with special healthcare needs (Mubanga et al., 2017). This process involves not only primary care physicians but also adult and pediatric subspecialists. A seamless and smooth transition from childhood to adult primary care providers is the goal for all youth with special needs (Sharma et al., 2014).
Transition can be facilitated through a dedicated clinical professional who bridges pediatric and adult primary care. Family physicians, internists, pediatricians, subspecialists, and other professionals each have defined roles within the medical home model. Open and ongoing communication among these professionals promotes continuous care (Mubanga et al., 2017). The transition can also occur between individual providers through a care transition plan within a system or group practice, which may ease the process for those who find the intricacies of youth healthcare challenging to navigate. Thoughtful transitional planning for youth with special healthcare needs helps make the process both manageable and successful.
"Provider roles in the medical home model"
"Shared patient, family, and provider accountability"
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