Planning for transition from pediatric to adult care for youth with mobility limitations

Background: The transition of youth with mobility limitations from pediatric to adult healthcare continues to pose major policy challenges. No studies have evaluated whether having a pediatric medical home is positively associated with receipt of transition planning advice in this population. Methods: This cross-sectional analysis examined associations between parent-reported mobility limitations, having a medical home, and receipt of three types of healthcare planning advice among youth, ages 12 – 17 years, in the 2005–2006 National Survey of Children with Special Health Care Needs (n = 18,083). Mobility limitations were defined by functional restrictions (sample n = 1,407). Associations were tested with survey-weighted logistic regression, controlling for important covariates (e.g. age, SES, condition severity). Results: Youth with mobility limitations were more likely than those with other special health care needs to report that their medical provider treated children only (OR = 1.28; 95% CI: 1.07, 1.53). Among youth with mobility limitations receiving care only from a pediatric provider, having a medical home was strongly associated with reported receipt of all types of transition advice (OR = 3.48; 95% CI: 2.34, 5.16). The family-centered care (2.09; 1.45, 3.00) and care coordination (1.73; 95% CI; 1.16, 2.58) sub-components of the medical home were most strongly associated with receipt of transition planning advice, while having a usual source of care, a personal doctor or nurse, or problem-free referrals were not significant. Conclusions: Family centered, coordinated care in a medical home appears to be beneficial in transition planning for youth with mobility limitations.