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Transition experiences and health care utilization among young adults with type 1 diabetes

机译：1型糖尿病青壮年的过渡经验和医疗保健利用

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Background: The purpose of this study was to describe the current status of adult diabetes care in young adults with type 1 diabetes and examine associations between health care transition experiences and care utilization. Methods: We developed a survey to assess transition characteristics and current care in young adults with type 1 diabetes. We mailed the survey to the last known address of young adults who had previously received diabetes care at a tertiary pediatric center. Results: Of 291 surveys sent, 83 (29%) were undeliverable and three (1%) were ineligible. Of 205 surveys delivered, 65 were returned (response rate 32%). Respondents (mean age 26.6 ± 3.0 years, 54% male, 91% Caucasian) transitioned to adult diabetes care at a mean age of 19.2 ± 2.8 years. Although 71% felt mostly/completely prepared for transition, only half received recommendations for a specific adult provider. Twenty-six percent reported gaps exceeding six months between pediatric and adult diabetes care. Respondents who made fewer than three diabetes visits in the year prior to transition (odds ratio [OR] 4.5, 95% confidence interval [CI] 1.2–16.5) or cited moving/relocation as the most important reason for transition (OR 6.3, 95% CI 1.3–31.5) were more likely to report gaps in care exceeding six months. Patients receiving current care from an adult endocrinologist (79%) were more likely to report at least two diabetes visits in the past year (OR 6.0, 95% CI 1.5–24.0) compared with those receiving diabetes care from a general internist/adult primary care doctor (17%). Two-thirds (66%) reported receiving all recommended diabetes screening tests in the previous year, with no difference according to provider type. Conclusion: In this sample, transition preparation was variable and one quarter reported gaps in obtaining adult diabetes care. Nevertheless, the majority endorsed currently receiving regular diabetes care, although visit frequency differed by provider type. Because locating patients after transition was incomplete, our findings suggest the need for standardized methods to track transitioning patients.
机译：背景：本研究的目的是描述1型糖尿病年轻人中成人糖尿病护理的现状，并探讨卫生保健过渡经验与护理利用之间的关联。方法：我们开展了一项调查，以评估1型糖尿病青壮年的过渡特征和当前护理。我们将调查结果邮寄到了以前在三级儿科中心接受过糖尿病护理的年轻人的最后一个已知住址。结果：在发送的291个调查中，有83个（29％）无法交付，有3个（1％）不符合条件。在提交的205个调查中，有65个被退回（答复率为32％）。受访者（平均年龄26.6±3.0岁，男性54％，白种人91％）以平均19.2±2.8岁的年龄过渡到成人糖尿病护理。尽管有71％的人感觉大部分/完全准备好过渡，但只有一半的人收到了针对特定成人提供者的建议。 26％的儿童和成人糖尿病护理之间的差距超过六个月。在过渡前一年中访视少于3次的受访者（优势比[OR] 4.5，95％置信区间[CI] 1.2-16.5）或将移动/重新安置作为过渡的最重要原因（OR 6.3、95 ％CI 1.3–31.5）更有可能报告超过六个月的医疗服务缺口。与接受一般内科/成人初诊的糖尿病患者相比，接受成人内分泌科医生当前护理的患者（79％）在过去一年中更有可能报告至少两次糖尿病访视（OR 6.0，95％CI 1.5-24.0）。护理医生（17％）。三分之二（66％）的人报告说在上一年接受了所有推荐的糖尿病筛查检查，但根据提供者的类型没有差异。结论：在该样本中，过渡准备工作是可变的，四分之一的人报告说在获得成人糖尿病护理方面存在差距。尽管如此，尽管访问频率因提供者类型的不同而不同，但大多数人目前仍接受定期糖尿病护理。由于过渡后患者的定位不完全，因此我们的发现表明需要采用标准化方法来跟踪过渡患者。

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