Health-Care Transition

The transition from pediatric to adult health care is a normal and important part of adolescent development. Failure to transition smoothly into adult care can put youth at increased risk of poor health outcomes and can delay maturation in other facets of life. This risk is particularly high for youth with special health-care needs, including those with mental health issues, and for youth with less social support, such as youth in foster care. Health-care providers who successfully facilitate a smooth transition into adult care help their patients stay healthy, and in turn increase their chances of thriving in their adult lives. Health-care transition is not a one-time event, but rather involves a series of discussions and readiness assessments between the patient, the patient's family, and the health-care provider. In 2011, the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), and American College of Physicians (ACP) released a clinical report establishing the importance of formal transition protocols and laying out a timeline for health-care transition. Since then, Got Transition, a national resource center, published the Six Core Elements of Health Care Transition™, a toolkit to help guide providers through the steps of transitioning their patients. Despite these guidelines, however, patients and providers still report considerable barriers to transition. Additionally, studies evaluating the effectiveness of transition programs are lacking. In 2018, an update to the 2011 clinical report was published that further defines the infrastructure, payment model accommodations, further research, and stakeholder education needed to facilitate a successful transition. This chapter highlights the importance of transition to adult care, the steps needed to facilitate a successful transition, and the barriers that patients and providers face as they navigate this significant milestone.