Prevalence, predictors, and moderators of transfer in primary care

初级保健中转诊的普遍性、预测因素和调节因素

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Abstract

OBJECTIVE: Health care transition from pediatric to adult primary care is understudied, and factors associated with successful transfer to adult care are not well understood. METHODS: The current study surveyed a sample of patients (N = 110) of transition age (18 - 22, M (age) = 19.42, SD (age) = 1.16) who attended a pediatric primary care practice. Mixed methods were used to assess the prevalence of successful transfer to adult primary care, factors associated with successful transfer, as well as barriers, facilitators, and recommendations for improving transition support. RESULTS: 45 % of the sample (n = 50) reported attending an adult primary care appointment. Contextual factors assessed (e.g., socio-economic status, disease complexity) and transition constructs (e.g., transition supports, transition behaviors, and transition attitudes) were not associated with transfer. No statistically significant predictors were identified. Exploratory patterns suggested that transition behaviors (e.g., managing medications, making appointments independently) may merit further investigation as a moderator. We report common barriers (e.g., logistics), facilitators (e.g., provider and family support), and recommendations (e.g., earlier transition support). DISCUSSION: Our preliminary findings suggest that given the association between behaviors and transition readiness, pediatric primary care settings might benefit from using screening to prioritize which patients might benefit from enhanced transition support.

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