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Author: Agency for and Quality
Publisher: CreateSpace
ISBN: 9781505859966
Category :
Languages : en
Pages : 118
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Book Description
There is no uniformly accepted age at which pediatric care is inappropriate and adult care should be sought for every patient. Nonetheless, some practices do have age cut-offs, and there comes a time when adult providers may be better able to serve the needs of patients whose medical concerns are more adult in nature, including for example reproductive and other issues. In addition, the inclusion of adults in pediatric practices can create discomfort and challenges for other pediatric patients and their families, and pediatricians can find themselves addressing medical issues of adults for which they are less prepared. Therefore, at some point, most pediatric patients should and do move into the adult care system. An effective transition process from a pediatric to an adult health system should ensure continuity of developmental and age-appropriate care. In 2002 the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the American College of Physicians (ACP) coauthored a consensus statement: "The goal of transition in health care for young adults with special health care needs is to maximize lifelong functioning and potential through the provision of high-quality, developmentally appropriate health care services that continue uninterrupted as the individual moves from adolescence to adulthood." This process can be challenging, particularly for children and youth with special health care needs (CSHCN), defined as individuals having or being at risk of "a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally." Examples of adolescent populations with special health care needs that need transition support range widely, including those with chronic illnesses such as diabetes or sickle cell disease and individuals with developmental disabilities that are associated with a host of challenges ranging from higher risks of specific health outcomes to the need for special support in navigating the health care system. Over the past few decades, the prevalence of childhood chronic conditions also has been steadily increasing, with an associated increased risk of a range of health problems and persistent impact into adulthood for many affected individuals. Potentially serious health-related consequences may be associated with suboptimal or incomplete transition to adult care. Gaps in care in transitions have been associated with poor health outcomes, increased hospitalizations and more complications and failure to access care in populations with diabetes, arthritis, and sickle cell disease. This report focuses specifically on transitions of care from pediatric to adult services for individuals with a chronic health condition.
Author: Agency for and Quality
Publisher: CreateSpace
ISBN: 9781505859966
Category :
Languages : en
Pages : 118
Get Book Here
Book Description
There is no uniformly accepted age at which pediatric care is inappropriate and adult care should be sought for every patient. Nonetheless, some practices do have age cut-offs, and there comes a time when adult providers may be better able to serve the needs of patients whose medical concerns are more adult in nature, including for example reproductive and other issues. In addition, the inclusion of adults in pediatric practices can create discomfort and challenges for other pediatric patients and their families, and pediatricians can find themselves addressing medical issues of adults for which they are less prepared. Therefore, at some point, most pediatric patients should and do move into the adult care system. An effective transition process from a pediatric to an adult health system should ensure continuity of developmental and age-appropriate care. In 2002 the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the American College of Physicians (ACP) coauthored a consensus statement: "The goal of transition in health care for young adults with special health care needs is to maximize lifelong functioning and potential through the provision of high-quality, developmentally appropriate health care services that continue uninterrupted as the individual moves from adolescence to adulthood." This process can be challenging, particularly for children and youth with special health care needs (CSHCN), defined as individuals having or being at risk of "a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally." Examples of adolescent populations with special health care needs that need transition support range widely, including those with chronic illnesses such as diabetes or sickle cell disease and individuals with developmental disabilities that are associated with a host of challenges ranging from higher risks of specific health outcomes to the need for special support in navigating the health care system. Over the past few decades, the prevalence of childhood chronic conditions also has been steadily increasing, with an associated increased risk of a range of health problems and persistent impact into adulthood for many affected individuals. Potentially serious health-related consequences may be associated with suboptimal or incomplete transition to adult care. Gaps in care in transitions have been associated with poor health outcomes, increased hospitalizations and more complications and failure to access care in populations with diabetes, arthritis, and sickle cell disease. This report focuses specifically on transitions of care from pediatric to adult services for individuals with a chronic health condition.
Author: Melissa L. McPheeters
Publisher:
ISBN:
Category :
Languages : en
Pages :
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BACKGROUND: Around 750,000 children in the United States with special health care needs transition to adult care annually. Fewer than half receive adequate support and services for their transition to adult care. Examples of programs with the potential to enhance transition for children with special heath care needs include use of a separate transition clinic, engagement of a transition coordinator, and a phased transfer within a clinical system. The potential for these programs to be effective is offset by barriers to their implementation. PURPOSE: We developed a technical brief on the state of practice and the current literature around transition care for children with special health care needs to describe current practice and to provide a framework for future research. METHODS: We had conversations with Key Informants representing clinicians who provide transition care, pediatric and adult providers of services for individuals with special health care needs, policy experts, and researchers. We searched online sources for information about currently available programs and resources. We conducted a literature search to identify currently available research on the effectiveness of focused transition programs. FINDINGS: The issue of how to provide good transition care for children with special health care needs warrants further attention. The numbers of children with special health care needs reaching adulthood are increasing, and the diversity of their clinical conditions is expanding. The Got Transition resource provides a framework for transition care that can be adapted to serve the individual needs of a given patient population, but there is little evidence that it is used to provide a framework for evaluation in the research literature. Despite identifying numerous descriptions of existing transition care programs or services, we identified only 25 evaluation studies, the majority of which did not include concurrent comparison groups. Most (n=8) were conducted in populations with diabetes, with a smaller literature (n=5) on transplant patients. We identified an additional 12 studies on a range of conditions, with no more than two studies on the same condition. Common components of care included use of a transition coordinator, a special clinic for young adults in transition and provision of educational materials, sometimes using computer-based programming. An important consideration going forward is recognizing that transition care for chronic conditions like diabetes may warrant a different approach than care provided for more heterogeneous and complex conditions, particularly those that include a behavioral or intellectual component. Care for some patients may be appropriately provided in primary care at the community level; for others, it may be appropriately provided only in highly specialized regional or academic centers. Research needs are wide ranging, including both substantive and methodologic concerns. Currently, the field lacks a consistent and accepted way of measuring transition success, and it will be essential to establish consistent goals in order to build an adequate body of literature to affect practice.
Author: Albert C. Hergenroeder
Publisher: Springer
ISBN: 3319728687
Category : Medical
Languages : en
Pages : 386
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Book Description
This comprehensive book thoroughly addresses all aspects of health care transition of adolescents and young adults with chronic illness or disability; and includes the framework, tools and case-based examples needed to develop and evaluate a Health Care Transition (HCT) planning program that can be implemented regardless of a patient’s disease or disability. Health Care Transition: Building a Program for Adolescents and Young Adults with Chronic Illness and Disability is a uniquely inclusive resource, incorporating youth/young adult, caregiver, and pediatric and adult provider voices and perspectives. Part I of the book opens by defining Health Care Transition, describing the urgent need for comprehensive transition planning, barriers to HCT and then offering a framework for developing and evaluating health care transition programs. Part II focuses on the anatomic and neuro-chemical changes that occur in the brain during adolescence and young adulthood, and how they affect function and behavior. Part III covers the perspectives of important participants in the HCT transition process – youth and young adults, caregivers, and both pediatric and adult providers. Each chapter in Part IV addresses a unique aspect of developing HCT programs. Part V explores various examples of successful transition from the perspective of five key participants in the transition process - patients, caregivers, pediatric providers, adult providers and third party payers. Related financial matters are covered in part VI, while Part VII explores special issues such as HCT and the medical home, international perspectives, and potential legal issues. Models of HCT programs are presented in Part VIII, utilizing an example case study. Representing perspectives from over 75 authors and more than 100 medical centers in North America and Europe, Health Care Transition: Building a Program for Adolescents and Young Adults with Chronic Illness and Disability is an ideal resource for any clinician, policy maker, caregiver, or hospitalist working with youth in transition.
Author:
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Category : Young adults with disabilities
Languages : en
Pages : 130
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Author: Thomas J. Coates
Publisher: Academic Press
ISBN: 1483276325
Category : Health & Fitness
Languages : en
Pages : 517
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Book Description
Promoting Adolescent Health: A Dialog on Research and Practice is a collection of essays that discusses the insights provided by professionals into the problems of encouraging adolescent health. The book presents the open dialog between the views of pediatrics, cardiologists, psychologists, health educators, sociologists, and nutrition scientists. The text gives discussions from a variety of perspectives on each of six problem areas: smoking, drugs and alcohol, sexuality, coronary risk factors, health-risk eating behaviors, and chronic disease. It also discusses the factors influential in smoking onset and describes the examination of health education and health promotion, adolescent medicine, developmental psychology, education, and research methodology. The book will provide valuable insights for anthropologists, psychiatrists, sociologists, students, and researchers in the field of adolescent behaviors.
Author: Helen M. Parsons
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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OBJECTIVE: To understand the evidence base for care interventions, implementation strategies, and between-provider communication tools among children with special healthcare needs (CSHCN) transitioning from pediatric to adult medical care services. DATA SOURCES: We searched Ovid MEDLINE(r), Ovid Embase(r), the Cochrane Central trials (CENTRAL) registry, and CINAHL(r) to identify studies through September 10, 2021. We conducted grey literature searches to identify additional resources relevant to contextual questions. REVIEW METHODS: Using a mixed-studies review approach, we searched for interventions or implementation strategies for transitioning CSHCN from pediatric to adult services. Two investigators screened abstracts and full-text articles of identified references for eligibility. Eligible studies included randomized controlled trials, quasi-experimental observational studies, and mixed-method studies of CSHCN, their families, caregivers, or healthcare providers. We extracted basic study information from all eligible studies and grouped interventions into categories based on disease conditions. We summarized basic study characteristics for included studies and outcomes for studies assessed as low to medium risk of bias using RoB-2. RESULTS: We identified 9,549 unique references, 440 of which represented empirical research; of these, 154 (16 major disease categories) described or examined a care transition intervention with enough detail to potentially be eligible for inclusion in any of the Key Questions. Of these, 96 studies met comparator criteria to undergo risk of bias assessment; however only 9 studies were assessed as low or medium risk of bias and included in our analytic set. Low-strength evidence shows transition clinics may not improve hemoglobin A1C levels either at 12 or 24 months in youth with type 1 diabetes mellitus compared with youth who received usual care. For all other interventions and outcomes, the evidence was insufficient to draw meaningful conclusions because the uncertainty of evidence was too high. Some approaches to addressing barriers include dedicating time and resources to support transition planning, developing a workforce trained to care for the needs of this population, and creating structured processes and tools to facilitate the transition process. No globally accepted definition for effective transition of care from pediatric to adult services for CSHCN exists; definitions are often drawn from principles for transitions, encompassing a broad set of clinical aspects and other factors that influence care outcomes or promote continuity of care. There is also no single measure or set of measures consistently used to evaluate effectiveness of transitions of care. The literature identifies a limited number of available training and other implementation strategies focused on specific clinical specialties in targeted settings. No eligible studies measured the effectiveness of providing linguistically and culturally competent healthcare for CSHCN. Identified transition care training, and care interventions to prepare pediatric patients and their families for transitioning from CSHCN to adult care, varied considerably. CONCLUSIONS: Little rigorous evidence exists to inform care interventions and implementation strategies. Significant barriers impede implementation of interventions, tools, and trainings to transition CSHCN, which may be reduced in future intervention development. This review highlights the need for more rigorous studies across the diverse populations of CSHCN in order to provide clearer answers for CSHCN, their families, caregivers, providers, funders, and policymakers.
Author:
Publisher:
ISBN:
Category : Health services administration
Languages : en
Pages : 28
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Author: National Research Council
Publisher: National Academies Press
ISBN: 0309309980
Category : Medical
Languages : en
Pages : 431
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Young adulthood - ages approximately 18 to 26 - is a critical period of development with long-lasting implications for a person's economic security, health and well-being. Young adults are key contributors to the nation's workforce and military services and, since many are parents, to the healthy development of the next generation. Although 'millennials' have received attention in the popular media in recent years, young adults are too rarely treated as a distinct population in policy, programs, and research. Instead, they are often grouped with adolescents or, more often, with all adults. Currently, the nation is experiencing economic restructuring, widening inequality, a rapidly rising ratio of older adults, and an increasingly diverse population. The possible transformative effects of these features make focus on young adults especially important. A systematic approach to understanding and responding to the unique circumstances and needs of today's young adults can help to pave the way to a more productive and equitable tomorrow for young adults in particular and our society at large. Investing in The Health and Well-Being of Young Adults describes what is meant by the term young adulthood, who young adults are, what they are doing, and what they need. This study recommends actions that nonprofit programs and federal, state, and local agencies can take to help young adults make a successful transition from adolescence to adulthood. According to this report, young adults should be considered as a separate group from adolescents and older adults. Investing in The Health and Well-Being of Young Adults makes the case that increased efforts to improve high school and college graduate rates and education and workforce development systems that are more closely tied to high-demand economic sectors will help this age group achieve greater opportunity and success. The report also discusses the health status of young adults and makes recommendations to develop evidence-based practices for young adults for medical and behavioral health, including preventions. What happens during the young adult years has profound implications for the rest of the life course, and the stability and progress of society at large depends on how any cohort of young adults fares as a whole. Investing in The Health and Well-Being of Young Adults will provide a roadmap to improving outcomes for this age group as they transition from adolescence to adulthood.
Author: Stephanie Porter
Publisher:
ISBN:
Category : Health planning
Languages : en
Pages : 86
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