Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Improving the transition between paediatric and adult healthcare: A systematic review.
Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
2011 (English)In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 96, no 6, p. 548-553Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: The transition between paediatric and adult care for young people with chronic illness or disability is often poorly managed, with adverse consequences for health. Although many agree that adolescent services need to be improved, there is little empirical data on which policies can be based.

OBJECTIVES: To systematically review the evidence of effectiveness of transitional care programmes in young people aged 11-25 with chronic illness (physical or mental) or disability, and identify their successful components.

DESIGN: A systematic literature review in July 2010 of studies which consistently evaluated health outcomes following transition programmes, either by comparison with a control group or by measurement pre-intervention and post-intervention.

RESULTS: 10 studies met the inclusion criteria, six of which showed statistically significant improvements in outcomes. Descriptive analysis identified three broad categories of intervention, directed at: the patient (educational programmes, skills training); staffing (named transition co-ordinators, joint clinics run by paediatric and adult physicians); and service delivery (separate young adult clinics, out of hours phone support, enhanced follow-up). The conditions involved varied (eg, cystic fibrosis, diabetes mellitus), and outcome measures varied accordingly. All six interventions that resulted in significant improvements were in studies of patients with diabetes mellitus, with glycosylated haemoglobin level, acute and chronic complications, and rates of follow-up and screening used as outcome measures.

CONCLUSIONS: The most commonly used strategies in successful programmes were patient education and specific transition clinics (either jointly staffed by paediatric and adult physicians or dedicated young adult clinics within adult services). It is not clear how generalisable these successful studies in diabetes mellitus will be to other conditions.

Place, publisher, year, edition, pages
2011. Vol. 96, no 6, p. 548-553
Keyword [en]
child health, transitional care programmes, paediatric care, chronic illness, transition clinics
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Science
Identifiers
URN: urn:nbn:se:kau:diva-35866DOI: 10.1136/adc.2010.202473PubMedID: 21388969OAI: oai:DiVA.org:kau-35866DiVA, id: diva2:805829
Available from: 2015-04-16 Created: 2015-04-16 Last updated: 2017-12-04Bibliographically approved
In thesis
1. Child Health, Health Services and Systems in UK and other European countries
Open this publication in new window or tab >>Child Health, Health Services and Systems in UK and other European countries
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background

This work in child population medicine describes child health problems, increases knowledge of health services, systems, and wider determinants, and makes recommendations for improvements.

Aims

To explore trends in UK child health and health service quality and highlight policy lessons from the UK and other European countries

To study child health and health services in western Europe and derive lessons from different approaches to common challenges

To enhance knowledge on child to adult transition care

To describe trends in UK and EU15+ child and adolescent mortality and seek explanations for deteriorating UK health system performance, and make recommendations for improving survival

Methods

Population level measures of health status and system performance; primary and secondary research on policies and practice for health system assessments. Quantitative: mortality rate trends, excess deaths, DALYs, healthcare processes Qualitative: case reports, system descriptions, analyses 

Results

European child survival has improved, but variably between countries. The UK has not matched recent EU mortality gains. There are 6,000 excess deaths annually in children under 15 years in EU14 countries.

There are child survival inequities; countries investing in social protection have lower mortality. Children in the UK, compared with other EU countries, are more likely to be poor than adults.

Non-communicable diseases are now dominant causes of child death, disease, and disability.

Mortality, processes, and outcomes of healthcare amenable conditions varies between countries. Better outcomes seem to be associated with flexible health care models promoting cooperation, team working, and transition.

Conclusions

Child health in Europe is improving, but unevenly. Child health systems are not adapting sufficiently to meet needs. Recommendations are made for improving health systems and services.

Abstract [en]

How do European countries compare when it comes to child health statistics? How do different child health services, systems, and wider determinants impact long term influences for good or harm? Why do some countries seem to do better than others in safeguarding their children’s and young people’s health and wellbeing? And what can we  do to make things better for children?

This thesis explores some of these difficult but important issues, and despite describing some serious signals of concern about child health, offers recommendations and clear ways forward for countries to ensure healthier futures for children.

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2015. p. 157
Series
Karlstad University Studies, ISSN 1403-8099 ; 2015:24
Keyword
child health, public health, health services and Systems assessment, UK, Europe
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Science
Identifiers
urn:nbn:se:kau:diva-35856 (URN)978-91-7063-637-0 (ISBN)
Public defence
2015-05-29, Fryxellsalen, Karlstad, 09:00 (English)
Opponent
Supervisors
Available from: 2015-05-07 Created: 2015-04-15 Last updated: 2017-08-15Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMed
In the same journal
Archives of Disease in Childhood
Public Health, Global Health, Social Medicine and Epidemiology

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 2758 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf