Challenges of intra-institutional transfer of care from paediatric to adult congenital cardiology

The need for retention as well as transition

Claudine M. Bohun, Patricia Woods, Christiane Winter, Julie Mitchell, Joel McLarry, Joseph Weiss, Craig Broberg

    Research output: Contribution to journalArticle

    11 Citations (Scopus)

    Abstract

    Background Transferring patients with CHD from paediatric to adult care has been challenging, especially across institutions. Within a single institution, some issues such as provider interaction, information exchange, or administrative directives should not play a significant role, and should favour successful transfer. Objective We studied patients who were eligible for transfer to the adult congenital heart disease service within our institution in order to identify factors associated with successful transfer to adult care providers versus failure to transfer. Methods Patients above18 years of age with CHD who were seen by paediatric cardiologists before January, 2008 were identified through a patient-care database. Records were reviewed to determine follow-up between 2008 and 2011 and to determine whether the patient was seen in the adult congenital cardiology clinic, paediatric cardiology clinic, or had no follow-up, and statistical comparisons were made between groups. Results After reviewing 916 records, 229 patients were considered eligible for transition to adult congenital cardiology. Of these, 77 (34%) were transferred successfully to adult congenital cardiology, 47 (21%) continued to be seen by paediatric cardiologists, and 105 (46%) were lost to follow-up. Those who transferred successfully differed with regard to complexity of diagnosis, insurance, and whether a formal referral was made by a paediatric care provider. Only a small fraction of the patients who were lost to follow-up could be contacted. Conclusion Within a single institution, with shared information systems, administrations, and care providers, successful transfer from paediatric to adult congenital cardiology was still poor. Efforts for successful retention are just as vital as those for transfer.

    Original languageEnglish (US)
    Pages (from-to)327-333
    Number of pages7
    JournalCardiology in the Young
    Volume26
    Issue number2
    DOIs
    StatePublished - Feb 9 2015

    Fingerprint

    Transition to Adult Care
    Cardiology
    Pediatrics
    Lost to Follow-Up
    Insurance
    Information Systems
    Heart Diseases
    Patient Care
    Referral and Consultation
    Databases

    Keywords

    • Adult congenital heart disease
    • lost to follow-up
    • retention
    • transfer of care
    • transition

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine
    • Pediatrics, Perinatology, and Child Health

    Cite this

    Challenges of intra-institutional transfer of care from paediatric to adult congenital cardiology : The need for retention as well as transition. / Bohun, Claudine M.; Woods, Patricia; Winter, Christiane; Mitchell, Julie; McLarry, Joel; Weiss, Joseph; Broberg, Craig.

    In: Cardiology in the Young, Vol. 26, No. 2, 09.02.2015, p. 327-333.

    Research output: Contribution to journalArticle

    Bohun, Claudine M. ; Woods, Patricia ; Winter, Christiane ; Mitchell, Julie ; McLarry, Joel ; Weiss, Joseph ; Broberg, Craig. / Challenges of intra-institutional transfer of care from paediatric to adult congenital cardiology : The need for retention as well as transition. In: Cardiology in the Young. 2015 ; Vol. 26, No. 2. pp. 327-333.
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    abstract = "Background Transferring patients with CHD from paediatric to adult care has been challenging, especially across institutions. Within a single institution, some issues such as provider interaction, information exchange, or administrative directives should not play a significant role, and should favour successful transfer. Objective We studied patients who were eligible for transfer to the adult congenital heart disease service within our institution in order to identify factors associated with successful transfer to adult care providers versus failure to transfer. Methods Patients above18 years of age with CHD who were seen by paediatric cardiologists before January, 2008 were identified through a patient-care database. Records were reviewed to determine follow-up between 2008 and 2011 and to determine whether the patient was seen in the adult congenital cardiology clinic, paediatric cardiology clinic, or had no follow-up, and statistical comparisons were made between groups. Results After reviewing 916 records, 229 patients were considered eligible for transition to adult congenital cardiology. Of these, 77 (34{\%}) were transferred successfully to adult congenital cardiology, 47 (21{\%}) continued to be seen by paediatric cardiologists, and 105 (46{\%}) were lost to follow-up. Those who transferred successfully differed with regard to complexity of diagnosis, insurance, and whether a formal referral was made by a paediatric care provider. Only a small fraction of the patients who were lost to follow-up could be contacted. Conclusion Within a single institution, with shared information systems, administrations, and care providers, successful transfer from paediatric to adult congenital cardiology was still poor. Efforts for successful retention are just as vital as those for transfer.",
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