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Transition of care in CHD: a single-centre experience: an enigma remains

Published online by Cambridge University Press:  29 September 2023

Christine Lopez ,
Brittany Glassberg ,
Alexandra Dembar ,
Maria Riasat ,
Alice Chan ,
Usha Govindarajulu ,
Kali A. Hopkins  and
Ali N. Zaidi Open the ORCID record for Ali N. Zaidi [Opens in a new window]
Christine Lopez
Affiliation:
Icahn School of Medicine at Mount Sinai, New York, NY, USA
Brittany Glassberg
Affiliation:
Icahn School of Medicine at Mount Sinai, New York, NY, USA
Alexandra Dembar
Affiliation:
Icahn School of Medicine at Mount Sinai, New York, NY, USA
Maria Riasat
Affiliation:
Department of Medicine, Mount Sinai Beth Israel, New York, NY, USA
Alice Chan
Affiliation:
Mount Sinai Adult Congenital Heart Disease Center, Mount Sinai Heart, New York, NY, USA
Usha Govindarajulu
Affiliation:
Center for Biostatistics, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Kali A. Hopkins
Affiliation:
Mount Sinai Adult Congenital Heart Disease Center, Mount Sinai Heart, New York, NY, USA
Ali N. Zaidi*
Affiliation:
Mount Sinai Adult Congenital Heart Disease Center, Mount Sinai Heart, New York, NY, USA Mount Sinai Children’s Heart Center, Kravis Children’s Hospital, New York, NY, USA
*
Corresponding author: Ali N. Zaidi; Email: ali.zaidi@mountsinai.org
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Abstract

Transition of care refers to the continuity of health care during the movement from one healthcare setting to another as care needs change during a chronic illness. We sought to describe social, demographic, and clinical factors related to successful transition in a tertiary urban care facility in patients with CHD. Patients were identified utilising the electronic medical record. Inclusion criteria were patients with CHDs aged ≥15 years seen in the paediatric cardiology clinic between 2013 and 2014. Deceased patients were excluded. Clinical and demographic variables were collected. Patient charts were reviewed in 2015–2021 to determine if included patients were a) still in paediatric cardiology care, b) transitioned to adult cardiology/adult CHD, or were c) lost to follow-up. A total of 322 patients, 53% male (N:172), 46% female (N:149) were included. Majority had moderately complex lesions (N:132, 41%). Most patients had public insurance (N:172, 53%), followed by private insurance (N:67, 21%), while 15% of patients (N:47) were uninsured. Only 49% (N = 159) had successful transition, while 22% (N = 70) continued in care with paediatric cardiology, and 29% (N = 93) were lost to follow-up. Severity of CHD (p = 0.0002), having healthcare insurance (p < .0001), presence of a defibrillator (p = 0.0028), and frequency of paediatric cardiology visits (p = 0.0005) were significantly associated with successful transition. Most patients lost to follow-up (N:42,62%) were either uninsured or had public insurance. Lack of successful transition is multifactorial, and further efforts are needed to improve the process in patients with CHD.

Keywords

Transition of careCHDloss to follow-up
Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 4 , April 2024 , pp. 727 - 733
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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