Association of provider scope of practice with successful transition for youth with special health care needs.
Association of provider scope of practice with successful transition for youth with special health care needs.
复制标题
提供者实践范围与有特殊医疗保健需求的青少年成功过渡的协会。
DOI：
10.1016/j.jadohealth.2010.06.011
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
S. Nageswaran
中科院分区：
文献类型：
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作者：
B. Nishikawa;T. Daaleman;S. Nageswaran
有特殊卫生保健需要的青少年（YSHCN）在从儿科向成人卫生保健过渡的过程中遇到了独特的挑战。虽然与医疗保健提供者讨论过渡可能是有益的，但目前还不清楚提供者的实践范围（仅针对儿童还是以寿命为导向）是否会推动这些讨论。我们研究了实践范围和过渡相关services.METHODSWe使用照顾者的反应，在2005-2006年全国调查的儿童有特殊的医疗保健需求之间的关联。我们比较了提供者只治疗儿童的青年和提供者也治疗成年人的青年（以寿命为导向）的过渡结果。个人和家庭层面的人口统计因素应用于logistic回归模型。与只提供儿童服务的年轻人相比，拥有终身服务的年轻人更有可能讨论成年后不断变化的健康需求（52%对43%）和成人健康保险（24%对21%）。在接受自我责任的鼓励方面没有差异（79%对78%）。这些协会持续调整人口统计学。CONCLUSIONSYSHCN更有可能报告讨论了有关问题过渡到成人医疗保健，如果他们的供应商治疗成人以及儿童。然而，所有YSHCN都缺乏关于成人健康保险的讨论。
PURPOSEYouth with special health care needs (YSHCN) encounter unique challenges in the transition from pediatric to adult healthcare. Although discussing transition with healthcare providers can be beneficial, it is unclear whether the providers' scope of practice (child-only vs. lifespan-oriented) drives these discussions. We examined the association between scope of practice and transition-related services.METHODSWe used caregivers' responses in the 2005–2006 National Survey of Children with Special Healthcare Needs. We compared transition outcomes for youth whose providers treated only children, and youth whose providers also treated adults (lifespan-oriented). Individual and household-level demographic factors were applied to logistic regression models.RESULTSYouth with lifespan-oriented providers were more likely than youth with child-only providers to have discussed changing health needs in adulthood (52% vs. 43%) and adult health insurance (24% vs. 21%). There was no difference in receiving encouragement toward self-responsibility (79% vs. 78%). These associations persisted after adjusting for demographics.CONCLUSIONSYSHCN are more likely to report having discussed issues related to transition into adult healthcare if their providers treat adults as well as children. However, discussion involving adult health insurance in particular was lacking for all YSHCN.