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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.

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 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.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Skogby S,Moons P,Johansson B,Sunnegårdh J,Christersson C,Nagy E,Winberg P,Hanséus K,Trzebiatowska-Krzynska A,Fadl S,Fernlund E,Kazamia K,Rydberg A,Zühlke L,Goossens E,Bratt EL

doi

10.1016/j.ijcard.2020.01.016

subject

Has Abstract

pub_date

2020-07-01 00:00:00

pages

51-57

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(19)32630-0

journal_volume

310

pub_type

杂志文章

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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.