228157 Planning for transition from pediatric to adult care for youth with mobility limitations

Monday, November 8, 2010 : 11:24 AM - 11:42 AM

Todd Edwards, PhD , Department of Health Services, University of Washington, Seattle, WA
Janice Bell, PhD, MPH , Maternal and Child Health Leadership Training Program, Department of Health Services, Seattle Quality of Life Group, University of Washington, School of Public Health, Seattle, WA
Donald L. Patrick, PhD, MSPH , Center for Disability Policy & Research, Seattle Quality of Life Group, University of Washington, Seattle, WA
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 20052006 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.

Learning Areas:
Provision of health care to the public
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. Discuss the health care transition issues facing youth with mobility limitations. 2. Explain associations between mobility limitations and measures of transition planning. 3. Describe components of the medical home that are associated with transition planning.

Keywords: Access and Services, Children With Special Needs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a research assistant professor with experience conducting research in this area.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.