Authors' objectives: We developed a technical brief on the state of practice and the current literature around transition care for children with special health care needs to describe current practice and to provide a framework for future research.

Authors' recommendations: The issue of how to provide good transition care for children with special health care needs warrants further attention. The numbers of children with special health care needs reaching adulthood are increasing, and the diversity of their clinical conditions is expanding. The Got Transition resource provides a framework for transition care that can be adapted to serve the individual needs of a given patient population, but there is little evidence that it is used to provide a framework for evaluation in the research literature. Despite identifying numerous descriptions of existing transition care programs or services, we identified only 25 evaluation studies, the majority of which did not include concurrent comparison groups. Most (n=8) were conducted in populations with diabetes, with a smallerliterature (n=5) on transplant patients. We identified an additional 12 studies on a range of conditions, with no more than two studies on the same condition. Common components of care included use of a transition coordinator, a special clinic for young adults in transition and provision of educational materials, sometimes using computer-based programming. An important consideration going forward is recognizing that transition care for chronic conditions like diabetes may warrant a different approach than care provided for more heterogeneous and complex conditions, particularly those that include a behavioral or intellectual component. Care for some patients may be appropriately provided in primary care at the community level; for others, it may be appropriately provided only in highly specialized regional or academic centers. Research needs are wide ranging, including both substantive and methodologic concerns. Currently, the field lacks a consistent and accepted way of measuring transition success, and it will be essential to establish consistent goals in order to build an adequate body of literature to affect practice.

Project Status: Completed

Year Published: 2014

URL for published report: http://www.effectivehealthcare.ahrq.gov/ehc/products/546/1920/children-special-needs-transition-report-140617.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)