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Outpatient volumes and medical staffing resources as predictors for continuity of follow-up care during transfer of adolescents with congenital heart disease
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.
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2020 (Engelska)Ingår i: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 310, s. 51-57Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: Providing continuous follow-up care to patients with congenital heart disease (CHD) remains a challenge in many settings. Previous studies highlight that patients with CHD experience discontinuation of follow-up care, but mainly describe a single-centre perspective, neglecting inter-institutional variations. Hospital-related factors above and beyond patient-related factors are believed to affect continuity of care. The present multicentre study therefore investigated (i) proportion of "no follow-up care"; (ii) transfer destinations after leaving paediatric cardiology; (iii) variation in proportions of no follow-up between centres; (iv) the association between no follow-up and outpatient volumes, and (v) its relationship with staffing resources at outpatient clinics.

METHODS: An observational, multicentre study was conducted in seven university hospitals. In total, 654 adolescents with CHD, born between 1991 and 1993, with paediatric outpatient visit at age 14-18 years were included. Transfer status was determined 5 years after the intended transfer to adult care (23y), based on medical files, self-reports and registries.

RESULTS: Overall, 89.7% of patients were receiving adult follow-up care after transfer; 6.6% had no follow-up; and 3.7% were untraceable. Among patients in follow-up care, only one remained in paediatric care and the majority received specialist adult CHD care. Significant variability in proportions of no follow-up were identified across centres. Higher outpatient volumes at paediatric outpatient clinics were associated with better continued follow-up care after transfer (OR = 1.061; 95% CI = 1.001 - 1.124). Medical staffing resources were not found predictive.

CONCLUSION: Our findings support the theory of hospital-related factors influencing continuity of care, above and beyond patient-related characteristics.

Ort, förlag, år, upplaga, sidor
Elsevier, 2020. Vol. 310, s. 51-57
Nyckelord [en]
Adolescent, Continuity of patient care, Heart defects, congenital, Patient transfer, Transition to adult care, Young adult
Nationell ämneskategori
Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi Kardiologi
Forskningsämne
medicin
Identifikatorer
URN: urn:nbn:se:umu:diva-170495DOI: 10.1016/j.ijcard.2020.01.016ISI: 000552054400012PubMedID: 31959410Scopus ID: 2-s2.0-85077930713OAI: oai:DiVA.org:umu-170495DiVA, id: diva2:1428922
Tillgänglig från: 2020-05-07 Skapad: 2020-05-07 Senast uppdaterad: 2023-03-23Bibliografiskt granskad

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Johansson, BengtRydberg, Annika

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International Journal of Cardiology
Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomiKardiologi

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