Outpatient volumes and medical staffing resources as predictors for continuity of follow-up care during transfer of adolescents with congenital heart disease
(2020) In International Journal of Cardiology 310. p.51-57- Abstract
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 follow-up 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... (More)
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 follow-up 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 adolescents with 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.
(Less)
- author
- organization
- publishing date
- 2020-07-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Adolescent, Continuity of patient care, Heart defects, congenital, Patient transfer, Transition to adult care, Young adult
- in
- International Journal of Cardiology
- volume
- 310
- pages
- 7 pages
- publisher
- Elsevier
- external identifiers
-
- scopus:85077930713
- pmid:31959410
- ISSN
- 0167-5273
- DOI
- 10.1016/j.ijcard.2020.01.016
- language
- English
- LU publication?
- yes
- id
- 1af46b95-d125-4494-973c-0735cf9ce276
- date added to LUP
- 2020-01-29 15:06:58
- date last changed
- 2024-09-19 16:15:46
@article{1af46b95-d125-4494-973c-0735cf9ce276, abstract = {{<p>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 follow-up 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 adolescents with 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.</p>}}, author = {{Skogby, Sandra and Moons, Philip and Johansson, Bengt and Sunnegårdh, Jan and Christersson, Christina and Nagy, Edit and Winberg, Per and Hanséus, Katarina and Trzebiatowska-Krzynska, Aleksandra and Fadl, Shalan and Fernlund, Eva and Kazamia, Kalliopi and Rydberg, Annika and Zühlke, Liesl and Goossens, Eva and Bratt, Ewa Lena}}, issn = {{0167-5273}}, keywords = {{Adolescent; Continuity of patient care; Heart defects, congenital; Patient transfer; Transition to adult care; Young adult}}, language = {{eng}}, month = {{07}}, pages = {{51--57}}, publisher = {{Elsevier}}, series = {{International Journal of Cardiology}}, title = {{Outpatient volumes and medical staffing resources as predictors for continuity of follow-up care during transfer of adolescents with congenital heart disease}}, url = {{http://dx.doi.org/10.1016/j.ijcard.2020.01.016}}, doi = {{10.1016/j.ijcard.2020.01.016}}, volume = {{310}}, year = {{2020}}, }