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Models of transitional care for young people with complex health needs: a scoping review
1Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
Insights
Effective transitional care models for young people with complex healthcare needs (CHNs) are lacking. Research is urgently needed to evaluate current practices and inform best approaches for this vulnerable population.
Area of Science:
- Healthcare transitions research
- Pediatric to adult healthcare services
- Complex care management
Background:
- Young people with complex healthcare needs (CHNs) face significant challenges transitioning from pediatric to adult health services.
- Successful transitional care models are crucial for this population.
- Cerebral palsy, autism spectrum disorders, and diabetes were used as exemplar conditions.
Purpose of the Study:
- To identify successful models of transitional care for young people with CHNs.
- To review existing literature and policy documents on transitional care.
- To assess the components of high-quality transitional care services.
Main Methods:
- Systematic scoping review of four databases (1980-2010) using transitional care search terms.
- Informal searches including expert recommendations and clinical team contact.
- Framework analysis of 19 selected papers using 10 transition categories and Normalization Process Theory.
Main Results:
- A limited literature identified service provision models for cerebral palsy and diabetes.
- No specific transitional care models were found for autism spectrum disorders.
- Most publications were descriptive or pilot studies with insufficient evaluation of implementation.
Conclusions:
- There is a significant paucity of evidence regarding effective transitional care processes and best practices for young people with CHNs.
- Current transitional care practices require urgent research and evaluation.
- More robust research is needed to inform the development of effective transitional care interventions.
Background:
Young people with complex healthcare needs (CHNs) face the challenge of transferring from child to adult health services. This study sought to identify successful models of transitional care for young people with CHNs. Three conditions were used as exemplars: cerebral palsy, autism spectrum disorders and diabetes.
Methods:
Scoping review: using search terms concerning transitional care, four databases were systematically searched for papers published in English between 1980 and April 2010. Additional informal search methods included recommendations from colleagues working with young people with each of the three conditions and making contact with clinical and research teams with expertise in transitional care. Inclusion and exclusion criteria were applied to define the papers selected for review. A separate review of policy documents, adolescent health and transition literature was also undertaken; 10 common summary categories for the components of high-quality services were identified. All papers were coded using a framework analysis which evaluated the data in two ways using the 10 transition categories and four elements of Normalization Process Theory that are important for successful implementation and integration of healthcare interventions.
Results:
Nineteen papers were selected for review. A very limited literature of models of service provision was identified for young people with cerebral palsy and diabetes. No models were identified for young people with autism spectrum disorders. Furthermore most publications were either descriptions of new service provision or time-limited pilot studies with little service evaluation or consideration of key elements of effective implementation.
Conclusions:
Despite agreement about the importance of effective transitional care, there is a paucity of evidence to inform best practice about both the process of and what constitutes effective transitional care. There is therefore an urgent need for research to evaluate current transitional care practices for young people with CHNs.
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Physicians
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