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Outpatient volumes and medical staffing resources as predictors for continuity of follow-up care during transfer of adolescents with congenital heart disease

Skogby, Sandra ; Moons, Philip ; Johansson, Bengt ; Sunnegårdh, Jan ; Christersson, Christina ; Nagy, Edit ; Winberg, Per ; Hanséus, Katarina LU ; Trzebiatowska-Krzynska, Aleksandra and Fadl, Shalan , et al. (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.

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organization
publishing date
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
2024-05-15 05:05:20
@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}},
}