Associations Between Health Care Transition Preparation Among Youth in the U.S. and Other Components of a Well-Functioning System of Services

Samhita M Ilango; Lydie A Lebrun-Harris; Jessica R Jones; Margaret A McManus; Mallory Cyr; Marie Y Mann; Sara Beth McLellan; Patience H White

doi:10.1016/j.jadohealth.2021.01.006

Associations Between Health Care Transition Preparation Among Youth in the U.S. and Other Components of a Well-Functioning System of Services

J Adolesc Health. 2021 Sep;69(3):414-423. doi: 10.1016/j.jadohealth.2021.01.006. Epub 2021 Mar 10.

Authors

Samhita M Ilango¹, Lydie A Lebrun-Harris², Jessica R Jones², Margaret A McManus³, Mallory Cyr⁴, Marie Y Mann², Sara Beth McLellan², Patience H White³

Affiliations

¹ The National Alliance to Advance Adolescent Health/Got Transition, Washington, D.C.. Electronic address: silango@thenationalalliance.org.
² Health Resources and Services Administration, Maternal and Child Health Bureau, Rockville, Maryland.
³ The National Alliance to Advance Adolescent Health/Got Transition, Washington, D.C.
⁴ Got Transition Cabinet Executive Team, Washington, D.C.

PMID: 33712385
DOI: 10.1016/j.jadohealth.2021.01.006

Abstract

Purpose: This study examines the relationships between receipt of health care transition (HCT) preparation among U.S. youth and five other components of a well-functioning system of services (family partnership in decision-making, medical home, early/continuous screening for special health care needs [SHCN], continuous/adequate health insurance, access to community-based services).

Methods: Data came from the combined 2016-2017 National Survey of Children's Health (n = 29,617 youth ages 12-17). Parents/caregivers answered questions about their child's health care experiences, which were combined to measure receipt of HCT preparation and the other five components of a well-functioning system of services. Unadjusted and adjusted analyses were conducted to examine associations, stratified by youth with and without special health care needs (YSHCN/non-YSHCN).

Results: About 16.7% of YSCHN and 13.9% of non-YSHCN received HCT preparation (p = .0040). Additionally, 25.3% of YSHCN and 27.3% of non-YSHCN received all five remaining components of a system of services (p = .1212). HCT preparation was positively associated with receipt of the combined five components among both YSHCN (adjusted prevalence rate ratio = 1.53, 95% confidence interval: 1.20-1.86) and non-YSHCN (adjusted prevalence rate ratio = 1.63, 95% confidence interval: 1.39-1.88). Regarding individual system of services components, early and continuous screening for SHCN was significantly associated with HCT preparation for both populations. For non-YSHCN only, having a medical home was associated with HCT preparation. The remaining three components were not associated with HCT preparation for either population after adjusting for sociodemographic characteristics.

Conclusions: Among both YSHCN and non-YSHCN, HCT preparation is positively associated with receipt of early and continuous screening for SHCN as well as the five combined components of a well-functioning system of services.

Keywords: Adolescent health; Health care transition; Preventive care; Systems of services; YSHCN.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adolescent
Child
Delivery of Health Care
Health Services Needs and Demand
Humans
Insurance, Health
Patient Transfer
Transition to Adult Care*

Grants and funding

U1TMC31756/HHS/HHS/United States