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The Inpatient Experience of Emerging Adults: Transitioning From Pediatric to Adult Care
Daniel Driver1,2, Michelle Berlacher2,3, Stephen Harder1,2
1Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, TX, USA.
Insights
Emerging adults (18-25) report significantly worse hospital experiences compared to older adults. This highlights critical gaps in understanding and meeting the needs of young adults during healthcare transitions.
Area of Science:
- Healthcare transitions
- Patient experience
- Adolescent and young adult medicine
Background:
- The transition from pediatric to adult healthcare is linked to poorer health outcomes, including mortality.
- Young adults face environmental, cultural, and process differences when moving to adult-focused medical facilities.
- This disparity suggests emerging adults may have a distinct hospital care experience.
Purpose of the Study:
- To compare patient experience across different age groups of emerging adults and established adults.
- To identify specific domains of care where emerging adults' experiences differ significantly.
Main Methods:
- Retrospective cohort study design.
- Analysis of patient experience data from a large urban safety net hospital.
- Comparison of three cohorts: 18-21 years, 22-25 years, and 26+ years.
Main Results:
- Emerging adults (18-21 and 22-25) reported substantially worse overall patient experience than adults aged 26 and older.
- A 38-percentile difference in overall experience was observed between emerging and established adults.
- Worsened experiences were prevalent across most domains, particularly in patient-provider relationships.
Conclusions:
- Healthcare systems must address the unique needs of emerging adults during transitions.
- There is a significant deficit in understanding the preferences and values of young adults in adult healthcare settings.
- Improving patient-provider relationships is crucial for enhancing the hospital experience for emerging adults.
Abstract:
The pediatric-to-adult care transition has been correlated with worse outcomes, including increased mortality. Emerging adults transitioning from child-specific healthcare facilities to adult hospitals encounter marked differences in environment, culture, and processes of care. Accordingly, emerging adults may experience care differently than other hospitalized adults. We performed a retrospective cohort study of patients admitted to a large urban safety net hospital and compared all domains of patient experience between patients in 3 cohorts: ages 18 to 21, 22 to 25, and 26 years and older. We found that patient experience for emerging adults aged 18 to 21, and, to a lesser extent, aged 22 to 25, was significantly and substantially worse as compared to adults aged 26 and older. The domains of worsened experience were widespread and profound, with a 38-percentile difference in overall experience between emerging adults and established adults. While emerging adults experienced care worse in nearly all domains measured, the greatest differences were found in those pertinent to relationships between patients and care providers, suggesting a substantial deficit in our understanding of the preferences and values of emerging adults.
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