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Transition of children with life-limiting conditions to adult care and healthcare use: a systematic review

BACKGROUND: Improved survival has led to increasing numbers of children with life-limiting conditions transitioning to adult healthcare services. There are concerns that transition may lead to a reduction in care quality and increases in emergency care. This review explores evidence for differences...

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Autores principales: Jarvis, Stuart W., Roberts, Daniel, Flemming, Kate, Richardson, Gerry, Fraser, Lorna K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group US 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8671088/
https://www.ncbi.nlm.nih.gov/pubmed/33654285
http://dx.doi.org/10.1038/s41390-021-01396-8
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author Jarvis, Stuart W.
Roberts, Daniel
Flemming, Kate
Richardson, Gerry
Fraser, Lorna K.
author_facet Jarvis, Stuart W.
Roberts, Daniel
Flemming, Kate
Richardson, Gerry
Fraser, Lorna K.
author_sort Jarvis, Stuart W.
collection PubMed
description BACKGROUND: Improved survival has led to increasing numbers of children with life-limiting conditions transitioning to adult healthcare services. There are concerns that transition may lead to a reduction in care quality and increases in emergency care. This review explores evidence for differences in health or social care use post- versus pre-transition to adult services. METHODS: MEDLINE, EMBASE, CINAHL, PsychINFO and Social Science Citation Index were searched. Studies published in English since 1990 including individuals with any life-limiting condition post- and pre-transition and reporting a health or social care use outcome were included. Data were extracted and quality assessed by one reviewer with 30% checked by an independent reviewer. RESULTS: Nineteen papers (18 studies) met the inclusion criteria. There was evidence for both increases and decreases (post- versus pre-transition) in outpatient attendance, inpatient admissions, inpatient bed days and health service costs; for increases in Emergency Department visits and for decreases in individuals receiving physiotherapy. CONCLUSIONS: Evidence for changes in healthcare use post- versus pre-transition is mixed and conflicting, although there is evidence for an increase in Emergency Department visits and a reduction in access to physiotherapy. More high-quality research is needed to better link changes in care to the transition. IMPACT: Evidence for changes in healthcare use associated with transition to adult services is conflicting. Emergency Department visits increase and access to physiotherapy decreases at transition. There are marked differences between care patterns in the United States and Canada.
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spelling pubmed-86710882021-12-29 Transition of children with life-limiting conditions to adult care and healthcare use: a systematic review Jarvis, Stuart W. Roberts, Daniel Flemming, Kate Richardson, Gerry Fraser, Lorna K. Pediatr Res Systematic Review BACKGROUND: Improved survival has led to increasing numbers of children with life-limiting conditions transitioning to adult healthcare services. There are concerns that transition may lead to a reduction in care quality and increases in emergency care. This review explores evidence for differences in health or social care use post- versus pre-transition to adult services. METHODS: MEDLINE, EMBASE, CINAHL, PsychINFO and Social Science Citation Index were searched. Studies published in English since 1990 including individuals with any life-limiting condition post- and pre-transition and reporting a health or social care use outcome were included. Data were extracted and quality assessed by one reviewer with 30% checked by an independent reviewer. RESULTS: Nineteen papers (18 studies) met the inclusion criteria. There was evidence for both increases and decreases (post- versus pre-transition) in outpatient attendance, inpatient admissions, inpatient bed days and health service costs; for increases in Emergency Department visits and for decreases in individuals receiving physiotherapy. CONCLUSIONS: Evidence for changes in healthcare use post- versus pre-transition is mixed and conflicting, although there is evidence for an increase in Emergency Department visits and a reduction in access to physiotherapy. More high-quality research is needed to better link changes in care to the transition. IMPACT: Evidence for changes in healthcare use associated with transition to adult services is conflicting. Emergency Department visits increase and access to physiotherapy decreases at transition. There are marked differences between care patterns in the United States and Canada. Nature Publishing Group US 2021-03-02 2021 /pmc/articles/PMC8671088/ /pubmed/33654285 http://dx.doi.org/10.1038/s41390-021-01396-8 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Systematic Review
Jarvis, Stuart W.
Roberts, Daniel
Flemming, Kate
Richardson, Gerry
Fraser, Lorna K.
Transition of children with life-limiting conditions to adult care and healthcare use: a systematic review
title Transition of children with life-limiting conditions to adult care and healthcare use: a systematic review
title_full Transition of children with life-limiting conditions to adult care and healthcare use: a systematic review
title_fullStr Transition of children with life-limiting conditions to adult care and healthcare use: a systematic review
title_full_unstemmed Transition of children with life-limiting conditions to adult care and healthcare use: a systematic review
title_short Transition of children with life-limiting conditions to adult care and healthcare use: a systematic review
title_sort transition of children with life-limiting conditions to adult care and healthcare use: a systematic review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8671088/
https://www.ncbi.nlm.nih.gov/pubmed/33654285
http://dx.doi.org/10.1038/s41390-021-01396-8
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