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Survey of Primary Care Pediatricians on the Transition and Transfer of Adolescents to Adult Health Care

Warren Alpert School of Medicine of Brown University, Division of General Academic Pediatrics, Hasbro Children's Hospital, Department of Pediatrics, Providence, robert_burke{at}brown.edu

Michael Spoerri, PT, MPH

Rhode Island Department of Health, Office of Special Health Care Needs, Providence

Ashley Price, MD

Warren Alpert School of Medicine of Brown University, Department of Family Medicine, Providence

Ann-Marie Cardosi, RN, BSN

Memorial Hospital of Rhode Island, Primary Care Center of Children with Special Needs, Pawtucket

Patricia Flanagan, MD

Warren Alpert School of Medicine of Brown University, Hasbro Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Providence, Rhode Island

The transition and transfer from pediatrics to adult health care of youth with and without special health care needs has become a focus of professional organizations, health care insurers, national policy makers, and providers. To understand transition and transfer at a primary care practice level, all primary care pediatricians in Rhode Island were surveyed. Responses were received from 103 of 169 (60.9%) practicing pediatricians. Few responders had practice policies on transfer. Most reported that transition should begin later than recommended. Few practices communicated with adult providers at transfer. Most reported that health insurers were of little help in transfer. Many pediatric practices had young adults after age 22 and many with special needs. Responders reported adolescents left their practices by 1 of 6 methods. The survey indicates the need for further study of transition and transfer and the need for additional training and education if transfers are to be successful.

Key Words: adolescents • transition • children and youth with special health care needs (CYSHCN)

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