A Data-Driven Approach Towards Understanding the Volume and Complexity of Young Adults With Chronic Medical...

To describe the volume, complexity, referral patterns and pre-transition supports provided to a cohort of adolescents/young adults (AYAs) transitioning to adult healthcare services from a tertiary paediatric centre.

This is a cross-sectional retrospective review of AYAs aged ≥ 17 years who attended their final paediatric clinic review 1 January 2017-31 December 2018 with one or more of the most common chronic medical conditions or who attended the most frequently attended medical clinics at The Royal Children's Hospital, Melbourne.

A total of 592 AYA (female = 283, 47.8%) met the inclusion criteria, with a mean (SD) age at the final RCH clinic of 18.6 (1.1) years. Of these, 115 (19.43%) were discharged to primary care, 44 (7.43%) disengaged from RCH prior to formal transition 44 (7.43%) and 3 (1.85%) died prior to completion of the transition process. Of the 430 AYA who were referred for ongoing specialist care, 384 (89.3%) were expected to be reviewed within the public system. Pre-transition support was accessed by 106/430 (24.65%) where 83 (19.3%) received standardised support. Higher representation in those who received coordinated care (n = 23, 5.35%) was seen in those; with ≥ 2 ongoing conditions, from regional postcodes, requiring interpreter assistance, with documented intellectual disability; and specific conditions such as epilepsy, inflammatory bowel disease and cerebral palsy.

Referral patterns and the nature of transition support at our institution are clinician/department dependent and therefore access may not be equitable between or even within condition groups. These data provide a platform from which robust post-transition outcome data and policy can be generated.