Multi-level factors linked to young adult primary care transitions: evidence from a state all-payer claims analysis

Area of Science:

• Health Services Research
• Public Health
• Pediatrics

Background:

• Delayed transition from pediatric to adult primary care can create significant gaps in medical care for young adults.
• Effective care transitions are essential for continuity and quality of healthcare.
• Multilevel factors influence the success of these transitions.

Purpose of the Study:

• To assess multilevel factors associated with timely transition from pediatric to adult primary care.
• To identify barriers and facilitators for successful care transitions in young adults.
• To inform policy for improving healthcare continuity.

Main Methods:

• Utilized state all-payer claims data for a cohort of 4,320 patients aged 17-20.
• Constructed primary care provider networks to identify family links.
• Employed logistic regression to analyze family, provider, and county-level factors influencing transition.

Main Results:

• Male sex was associated with lower odds of transitioning to adult primary care.
• Having family members seeing a pediatrician also correlated with lower transition rates.
• Residing in counties with high pediatric care capacity or low adult primary care capacity reduced transition odds.

Conclusions:

• Family connections to pediatric care and strong county-level pediatric care capacity are associated with non-transition to adult primary care.
• Multiple factors at different levels contribute to challenges in transitioning to adult primary care.
• Understanding these factors is vital for developing effective state and national policies to support care transitions.