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Pediatrics / Division of Adolescent Medicine / Delayed Transition of Care

Delayed Transition of Care: A National Study of Visits to Pediatricians by Young Adults

Investigators: Robert J. Fortuna, M.D., M.P.H., Jill S. Halterman, M.D., M.P.H., Tiffany Pulcino, M.D., M.P.H., Brett W. Robbins, M.D.

The Problem

Despite numerous policy statements and an increased focus on transition of care, little is known about young adults who experience delayed transition to adult providers. Our goal is to understand the extent of delayed transition for young adults. In cases where a young person has a serious or chronic illness, the transition to adult providers and healthcare systems is especially important for appropriate care and treatment to continue.


We used cross-sectional data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey between 1998 and 2008 to examine delayed transition among young adults ages 22 to 30. We defined delayed transition as continuing to visit a pediatrician after the age of 21 years.


Table 3: CharacteristicsOverall, we found that most ambulatory health care visits by young adults were to adult providers. However, a small proportion, but approximately 445,000 visits by young adults, were to pediatricians. We did not find a significant increase or decrease in delayed transition during the past decade. In adjusted models, visits by young adults to pediatric healthcare providers were more likely associated with chronic disease, with public health insurance, or with no health insurance.


Visits by young adults with chronic disease, public health insurance, or no health insurance were more likely to indicate delayed transitions. Patients at risk for difficulty transitioning to adult health care should be identified early and systems should be established to improve access and transitions to adult healthcare.

Full Article: Delayed Transition of Care: A National Study of Visits to Pediatricians by Young Adults