Incorporating the Six Core Elements of Health Care Transition Into a Medicaid Managed Care Plan: Lessons Learned From a Pilot Project

McManus, Margaret A.; White, Patience H.; Pirtle, Robin; Hancock, C Gold; Ablan, Michael; Corona-Parra, Raquel

doi:10.1016/j.pedn.2015.05.029

Cited by 75 publications

(39 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Specifically for childhood-onset diseases, the transition process should start by early adolescence (11 years) (ideal) or 14 years at the latest (essential) in order to allow the development of the necessary self-care skills and optimise educational and vocational outcomes 63 64. For YP who are diagnosed over the age of 14 years, the transition process should start at the time of diagnosis with the skills and support for transition built-up over time.…”

Section: Resultsmentioning

confidence: 99%

EULAR/PReS standards and recommendations for the transitional care of young people with juvenile-onset rheumatic diseases

et al. 2016

View full text Add to dashboard Cite

To develop standards and recommendations for transitional care for young people (YP) with juvenileonset rheumatic and musculoskeletal diseases ( jRMD). The consensus process involved the following: (1) establishing an international expert panel to include patients and representatives from multidisciplinary teams in adult and paediatric rheumatology; (2) a systematic review of published models of transitional care in jRMDs, potential standards and recommendations, strategies for implementation and tools to evaluate services and outcomes; (3) setting the framework, developing the process map and generating a first draft of standards and recommendations; (4) further iteration of recommendations; (5) establishing consensus recommendations with Delphi methodology and (6) establishing standards and quality indicators. The final consensus derived 12 specific recommendations for YP with jRMD focused on transitional care. These included: high-quality, multidisciplinary care starting in early adolescence; the integral role of a transition coordinator; transition policies and protocols; efficient communications; transfer documentation; an open electronic-based platform to access resources; appropriate training for paediatric and adult healthcare teams; secure funding to continue treatments and services into adult rheumatology and the need for increased evidence to inform best practice. These consensus-based recommendations inform strategies to reach optimal outcomes in transitional care for YP with jRMD based on available evidence and expert opinion. They need to be implemented in the context of individual countries, healthcare systems and regulatory frameworks.

show abstract

Section: Resultsmentioning

confidence: 99%

EULAR/PReS standards and recommendations for the transitional care of young people with juvenile-onset rheumatic diseases

et al. 2016

View full text Add to dashboard Cite

show abstract

“…14 Further, incorporating GOT Transition's six core elements may result in practice-level improvements that promote successful transition (box 1). 33 In addition, several diabetes-specific transition care resources are available to pediatric providers, including transition planning checklists and clinical summary templates. 28 Assessment tools such as the Transition Readiness Assessment Questionnaire (TRAQ) 34 or the Am I ON TRAC for Adult Care (ON TRAC) questionnaire 35 are also available to guide pediatric providers in preparing adolescents for transition.…”

Section: Discussionmentioning

confidence: 99%

Improving the transition from pediatric to adult diabetes care: the pediatric care provider's perspective in Quebec, Canada

Nakhla

Bell

Wafa

et al. 2017

BMJ Open Diab Res Care

View full text Add to dashboard Cite

ObjectivesThe transition from pediatric to adult care is a high-risk period for the emerging adult with diabetes. We aimed to determine adequacy of pediatric transition care structures and explore the pediatric diabetes care provider’s perceptions of transition care.Research design and methodsIn-depth interviews with pediatric diabetes care providers from 12 diabetes centers in Quebec were conducted. We queried alignment with Got Transition’s six core elements of healthcare transition, experiences, and barriers to transition care. Interview transcripts were reviewed for themes.ResultsThree centers (25%) reported having any elements of formal and structured transition care preparation and planning. When referrals were within center (n=8), pediatric providers perceived that transition was smoother; information sharing relied heavily on verbal communication rather than documented medical summaries. Barriers included lack of adult providers, less flexibility in adult care scheduling, patient struggles with multiple new adult responsibilities, and insufficient understanding by adult providers of these challenges. There was a perception that the quality of pediatric care was better than adult care. Moving out of the pediatric care geographical region appeared to increase risk for poor follow-up. Patient satisfaction and regular follow-up in adult care were thought to be good measures of transition success. Programs that included overlap between pediatric and adult care were perceived as ideal.ConclusionsImportant gaps in transition care practices persist. Efforts should focus on improving education in transition practices for pediatric care providers and establishing formal transition policies and structures at the institutional level.

show abstract

“…32–34 Recommendations from transition interventions evaluated for other CSHCN include incorporating a structured multidisciplinary transition program, improving availability of resources, training, and staff, starting the transition process by ages 12–14, expanding the role in transition of nurse care managers, pediatricians, and adult clinicians, and offering incentives to providers for completing transition planning components. 35–37 Our findings provide a baseline national estimate of the percentage of adolescents with CHD and their parents receiving transition planning by their provider, what subgroups of adolescents with CHD receive transition planning, and the desire by parents for transition planning for their children. As more centers implement successful transition planning interventions into their patient practice, these national estimates should be updated.…”

Section: Discussionmentioning

confidence: 92%

Preparing adolescents with heart problems for transition to adult care, 2009-2010 National Survey of Children with Special Health Care Needs

Downing

Oster

Farr

2017

Congenital Heart Disease

View full text Add to dashboard Cite

Objective A substantial percentage of children with congenital heart disease (CHD) fail to transfer to adult care, resulting in increased risk of morbidity and mortality. Transition planning discussions with a provider may increase rates of transfer, yet little is known about frequency and content of these discussions. We assessed prevalence and predictors of transition-related discussions between providers and parents of children with special healthcare needs (CSHCN) and heart problems, including CHD. Design Using parent-reported data on 12- to 17-year-olds from the 2009–2010 National Survey of CSHCN, we calculated adjusted prevalence ratios (aPR) for associations between demographic factors and provider discussions on shift to adult care, future insurance, and adult healthcare needs, weighted to generate population-based estimates. Results Of the 5.3% of adolescents with heart problems in our sample (n =724), 52.8% were female, 65.3% white, 62.2% privately insured, and 37.1% had medical homes. Less than 50% had parents who discussed with providers their child’s future health insurance (26.4%), shift to adult care (22.9%), and adult healthcare needs (49.0%). Transition planning did not differ between children with and without heart problems (aPR range: 1.0–1.1). Among parents of CSHCN with heart problems who did not have discussions, up to 66% desired one. Compared to 1-/13-year-olds, a larger percentage of 16-/17-year-olds had parents who discussed their shift to adult care (aPR 2.1, 95% confidence interval (CI) [1.1, 3.9]), and future insurance (aPR 1.8, 95% CI [1.1, 2.9]). Having a medical home was associated with discussing adult healthcare needs (aPR 1.5, 95% CI [1.2, 1.8]) and future insurance (aPR 1.8, 95% CI [1.3, 2.6]). Conclusions Nationally, less than half of adolescents with heart problems had parents who discussed their child’s transition with providers, which could be contributing to the large percentage of CHD patients who do not successfully transfer to adult care.

show abstract

Incorporating the Six Core Elements of Health Care Transition Into a Medicaid Managed Care Plan: Lessons Learned From a Pilot Project

Cited by 75 publications

References 10 publications

EULAR/PReS standards and recommendations for the transitional care of young people with juvenile-onset rheumatic diseases

EULAR/PReS standards and recommendations for the transitional care of young people with juvenile-onset rheumatic diseases

Improving the transition from pediatric to adult diabetes care: the pediatric care provider's perspective in Quebec, Canada

Preparing adolescents with heart problems for transition to adult care, 2009-2010 National Survey of Children with Special Health Care Needs

Contact Info

Product

Resources

About