Transitioning from pediatric to adult health care: the experience of patients and families.

249 Optimal health care is achieved when each person, at every age, receives medically and developmentally appropriate care (McManus et al., 2013). As health care outcomes improve for children with complex medical conditions, the movement toward adult care is an expected and desired outcome (Davies, Rennick, & Majnemer, 2011). As early as 2002, a consensus statement of the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the American College of Physicians (ACP)-American Society of Internal Medicine (ASIM) emphasized the importance of supporting and facilitating the transition of adolescents with special health care needs into young adulthood (AAP, AAFP, & ACP-ASIM, 2002; McManus et al., 2013). Recently, the same three organizations extended their statement in a clinical report, “Supporting the Health Care Transitions From Adolescence to Adulthood in the Medical Home” (AAP, AAFP, & ACP; Transitions Clinical Report Authoring Group, 2011). Further, the Maternal Child Health Bureau made preparation for adulthood one of six core outcomes defining a high-performing system of care for children with special health care needs (Lotstein et al., 2009). This transition outcome states that these youth should receive the services necessary to make appropriate transitions to adult health care, as well as to both work opportunities and independence (Lotstein et al., 2009). According to Tysbina, Kingnoth, Maxwell, Bayley, and Lindsey (2012), advances in health care have led to changes in the epidemiology of childhood chronic illness: