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Measuring the "triple aim" in transition care: a systematic review
Megan Prior1, Margaret McManus2, Patience White2
1The National Alliance to Advance Adolescent Health, Washington, District of Columbia; and Georgetown University School of Medicine, Washington District of Columbia mlp59@georgetown.edu.
Pediatrics
|November 26, 2014
Summary
Adolescent health care transition programs lack consistent evaluation. A comprehensive approach measuring population health, patient experience, and cost is needed for better outcomes.
Area of Science:
- Health Services Research
- Adolescent Medicine
- Healthcare Management
Background:
- Adolescents face significant risks during the transition from pediatric to adult healthcare without adequate support.
- Existing transition interventions often lack comprehensive efficacy evaluation.
- Understanding current healthcare transition measurement is crucial for improving services.
Purpose of the Study:
- To examine and categorize existing healthcare transition measures.
- To utilize the "Triple Aim" framework (experience of care, population health, cost of care) for categorization.
- To identify gaps in transition program evaluation.
Main Methods:
- Conducted a systematic literature search of Ovid Medline and CINAHL (1995-2013).
- Two independent reviewers screened studies evaluating healthcare transition interventions.
- Classified measures according to the Triple Aim domains: population health, experience of care, and costs of care.
Main Results:
- 33 studies met inclusion criteria from 2282 initially identified.
- Population health measures were most common (27 studies), often disease-specific.
- Cost (15 studies, mainly service utilization) and experience of care (8 studies, mainly satisfaction) were less frequently measured.
- Only 3 studies assessed all three Triple Aim domains.
Conclusions:
- Healthcare transition programs are evaluated inconsistently across population health, patient experience, and cost.
- A more robust and standardized set of measures is required to demonstrate the effectiveness of transition programs.
- Improved measurement is essential for enhancing the quality of care for adolescents transitioning to adult healthcare systems.