Pediatric Urology Providers' Perceptions and Attitudes on Transitional Urologic Care in a Single-Payer Healthcare System

Urol Pract. 2024 May 17:101097UPJ0000000000000619. doi: 10.1097/UPJ.0000000000000619. Online ahead of print.

Abstract

Introduction: Advances in healthcare have improved outcomes for pediatric patients with congenital neuro-urological conditions, highlighting the need for an effective transition from pediatric to adult care. This study investigates Canada's transitional urologic care within its single-payer healthcare system, focusing on the active members of Pediatric Urologists of Canada's (PUC) practices, perceptions, and attitudes towards transitional urologic care.

Methods: A survey was distributed to 35 Pediatric Urologists of Canada (PUC) members from July 2023 to January 2024, which collected data on transitional care practices and available Transitional Urology (TU) clinics. It also focused on a service overview, covering aspects such as the responder's geographic and institutional affiliations, clinical practice characteristics involving transitional care, perceived challenges, and strategies for care enhancement.

Results: Nationwide engagement emphasized a commitment to improving transitional care, with a significant proportion of respondents (64%) having over 10 years of practice, reflecting substantial experience in addressing transitional care challenges. The survey identified 4 dedicated transitional care clinics, 3 of which are active, pointing to concerted efforts towards specialized service provision. The major challenges identified include the lack of adult transitional care initiatives and governmental support. Recommendations for improvement should focus on standardizing transition protocols and boosting patient education. The survey also underscored the necessity of protocolized care for Spina Bifida-Neurogenic Bladder and complex urogenital conditions.

Conclusion: This study highlights the active efforts and existing challenges within Canada's transitional urologic care system, particularly emphasizing operational transitional care clinics as a crucial step forward in catering to transitioning patients' needs.

Keywords: adolescence; healthcare system; pediatrics; transitional care; urologic care.