3 years ago

Ambulatory Care Utilization Among Patients with Spina Bifida: Change in Care from Childhood to Adulthood

We examined the ambulatory health care visit utilization of spina bifida children, adults who transitioned to adult care, and adults who continued to seek care in a pediatric setting. Methods We evaluated utilization over a one-year period for SB patients who visited any outpatient medical clinic within an integrated health care system. Patients were categorized as pediatric (<18) or adult (> 18). Adults were divided into those who did not fully transition to adult care (DNT) and patients who fully transitioned (adult). Frequency and type of health care utilization were compared. Sub-analysis was performed for patients aged 18-25 to examine variables associated with successful complete transition to adult care. Results Over one year, 382 children, 88 DNT, and 293 adult SB patients had 4,931 clinic visits. Children had greater ambulatory care utilization (7.25 visits/year) compared to fully transitioned adults (5.33 visits/year, p=0.046). Children more commonly visited surgery clinics (52.3% of visits) and adults more commonly visited medical clinics (48.9%) (p<0.005). Adult transitioned patients were more likely to be female (p=0.004). Of patients 18-25 years old, those who did not transition to adult care had similar outpatient visit types but higher utilization of inpatient and emergency care than those who transitioned. Conclusions SB children utilized more ambulatory care than adults and were more likely to visit a surgical specialist. Adult SB patients who successfully transitioned to adult care were more likely to be female and patients who failed to transition were more likely to have more inpatient and emergency care.

Publisher URL: www.sciencedirect.com/science

DOI: S0022534717778159

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