Health Care Services and the Transition to Young Adulthood: Challenges and Opportunities
Health Care Services and the Transition to Young Adulthood: Challenges and Opportunities
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DOI：
10.1016/j.acap.2010.11.010
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发表时间：
2011-03-01
影响因子：
3.1
通讯作者：
Irwin, Charles E., Jr.
中科院分区：
文献类型：
--
作者：
Park, M. Jane;Adams, Sally H.;Irwin, Charles E., Jr.
目的：本研究的目的是探讨潜在的作用，医疗保健系统在成功过渡到青年成年期的所有青少年，重点是青少年与特殊医疗保健需求（ASHCN），并评估该系统的地位，填补该role.METHOD：研究和概念框架解决成功的过渡和运作进行了审查。提出了一个框架，描述了医疗保健服务在转型中的作用。卫生保健系统的地位，在促进健康的过渡进行了评估，包括全国调查的儿童有特殊的医疗保健需求2005-2006年的主要成果ASHCN.RESULTS分析：虽然大多数国家的努力，以确定所需的技能，为过渡集中在职业/职业技能，一些框架整合更广泛的问题，如健康，心理社会发展，和公民参与。青少年的过渡问题一般很少受到关注;但是，这些问题已为ASHCN阐明。然而，只有五分之二的ASHCN接受过渡性护理，ASHCN在其他核心结果方面表现不佳。有心理健康状况的ASHCN比有身体健康状况的ASHCN的结果更差。我们的健康过渡框架包括以下内容：1）青少年可以获得全面的医疗保健系统，2）避免可预防的问题，3）管理慢性问题。目前的医疗保健系统福尔斯达不到这些目标。结论：医疗保健服务可以潜在地发挥作用，促进健康的过渡到年轻的成年人，但是，存在许多差距。虽然卫生保健改革法案解决了一些差距，但需要努力整合青少年的发展需求和解决心理健康问题。
OBJECTIVE: The aim of this study was to examine the potential role of the health care system in the successful transition to young adulthood for all adolescents, with emphasis on adolescents with special health care needs (ASHCN), and to evaluate the system's status in filling that role.METHOD: Research and conceptual frameworks addressing successful transitions and functioning were reviewed. A framework describing a role for health care services in the transition was presented. The health care system's status in promoting healthy transitions was evaluated, including National Survey of Children with Special Health Care Needs 2005-2006 analyses of key outcomes for ASHCN.RESULTS: Although most national efforts to define skills needed for the transition have focused on career/vocational skills, a few frameworks integrate broader issues such as health, psychosocial development, and civic engagement. Adolescent transitional issues have generally received little attention; however, these have been articulated for ASHCN. Nevertheless, only 2 in 5 ASHCN receive transitional care, and ASHCN fare poorly on other core outcomes. ASHCN with mental health conditions fare worse on outcomes than those with physical health conditions. Our framework for healthy transitions includes the following: 1) adolescents can access a comprehensive health care system, 2) preventable problems are avoided, and 3) chronic problems are managed. The present health care system falls short of accomplishing these.CONCLUSIONS: Health care services can potentially play a role in facilitating a healthy transition to young adulthood; however, many gaps exist. Although the health care reform act addresses some gaps, efforts that integrate adolescents' developmental needs and address mental health issues are needed.