Abstract
ABSTRACTObjective To identify among pediatric surgeons across Brazil how the transition of pediatric patients to adult clinics is carried out.Methods A questionnaire was emailed to pediatric surgeons registered with the Associação Brasileira de Cirurgia Pediátrica in 2018. The data assessed included training time, maximum age of care, subspecialty of practice, outpatient follow-up of adult patients, reason for continuing care of adult patients, referral to adult specialties, concern with transition of care, and what has been done to improve it.Results Most pediatric surgeons had more than 20 years of experience, and approximately 61% worked simultaneously at a public hospital, private hospital and private office. The maximum age of care at public, private hospitals and private offices proved to be quite varied. The follow-up of patients aged over 18 years at public hospitals, private hospitals and private clinics wase 32%, 23.58% and 20.75%, respectively. The main reason for patients aged over 18 years continued to be accompanied by pediatric surgeons was lack of knowledge about the disease by adult specialties. Most patients were referred to the adult specialty of the hospital, and roughly 37% of pediatric surgeons responded that they were in contact with the adult specialty. Most believed in autonomy of care of their patients and were concerned with transition of care.Conclusion Transition of care is a relevant issue that needs to be studied and debated to ensure an appropriate long-term follow-up.
Highlights
Pediatric surgery is a recent surgical specialty that treats patients within the age group of zero to 18 years
A questionnaire prepared by the authors on a virtual platform was kindly emailed by the Associação Brasileira de Cirurgia Pediátrica [Brazilian Association of Pediatric Surgery] (CIPE) to registered pediatric surgeons from all over the country, in 2018 (Appendix 1)
A standardized Informed Consent Form (ICF) standardized by Universidade Federal de São Paulo (UNIFESP) was available for reading at the beginning of the questionnaire, and its completion was considered as acceptance
Summary
Pediatric surgery is a recent surgical specialty that treats patients within the age group of zero to 18 years. The complexity of the conditions, especially congenital diseases, demands longer follow-up. There is currently growing concern by several pediatric specialties about the best way to carry out the transition of these adolescent patients to adult settings. The number of publications on this subject has increased in recent years; it is still little addressed, especially in surgical specialties, nationally or internationally. The transition of care consists in the process of preparing referral of adolescents and young adults from pediatric care to adult settings. It includes initial planning, the transference itself, and the support provided throughout adulthood. The process is usually not well coordinated.[1]
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