Transition of Care to Late Adolescent/Adults in Paediatric Surgery: Perspectives From Indian Paediatric Surgeons

As survival rates improve for children with surgical conditions, there is a growing need for structured transition of care (TOC) for adolescence and adulthood. This study aimed to assess the attitudes and practices of Indian pediatric surgeons regarding TOC in pediatric surgery.

A cross-sectional survey was conducted from January to September 2025, using a pre-tested, validated, structured online questionnaire comprising both quantitative and open-ended qualitative questions that covered practice patterns, awareness, and implementation of TOC, delivered via a secure web platform.

A total of 120 pediatric surgeons participated, including 78/120 (65%) from the government/autonomous/private teaching sectors (TS) and 42/120 (35%) from the private nonteaching sector (PS); 50/120 (41.7%) had >15-year experience. Most centers treated patients aged 18 years or less (67/120, 55.8%), with no sectoral difference (χ² = 6.98, P = 0.072). Awareness of TOC clinics was reported by 50/120 (41.7%). Equivalent TOC models were more common in TS than PS (17.9% vs. 4.8%; χ² = 4.21, P = 0.040). TS surgeons more often required adult surgeon assistance (χ² = 22.61, P < 0.001) and expressed greater need for formal TOC policy (94.9% vs. 76.2%; χ² = 11.02, P = 0.001). Qualitative analysis suggested a lack of social workers, training gaps, and systemic issues, including infrastructure and coordination challenges, which hinder the implementation of structured TOC programs (82.5%, 66.6%, and additional systemic factors).

Resource constraints, workforce shortages, and inadequate training are structural barriers rather than attitudinal resistance in TOC. Most pediatric surgeons support collaboration, underscoring the need for interdisciplinary efforts that can encourage policymakers to prioritize joint care initiatives.