期刊
INTERNATIONAL JOURNAL OF CARDIOLOGY
卷 310, 期 -, 页码 51-57出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ijcard.2020.01.016
关键词
Adolescent; Continuity of patient care; Heart defects, congenital; Patient transfer; Young adult; Transition to adult care
资金
- Swedish Heart-Lung Foundation
- Swedish Research Council for Health, Working Life and Welfare-FORTE [2016-07259]
- Institute of Health and Care Sciences of the University of Gothenburg
- South African Medical Research Council through FORTE
- National Research Foundation of South Africa
- MRC [MR/S005242/1] Funding Source: UKRI
- Forte [2016-07259] Funding Source: Forte
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 followup 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 adolescentswith 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. (c) 2020 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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