Affiliations: Departments of Pediatrics and Medicine, Warren Alpert
Medical School of Brown University, Providence, RI, USA | Departments of Orthopedics and Surgery, Warren Alpert
Medical School of Brown University, Providence, RI, USA | Department of Family Medicine and Community Health,
University of Massachusetts Medical School, Worcester, MA, USA | Department of Oncology, St. Jude's Children's Research
Hospital, Memphis, TN, USA | University of Massachusetts Medical School, Worcester,
MA, USA | Baystate Children's Hospital, Springfield, MA,
USA
Note: [] Corresponding author: Suzanne McLaughlin, Warren Alpert Medical
School of Brown University. 593 Eddy Street, Physicians' Office Building, Suite
#230. Providence, RI 02903, USA. Tel.: +1 401 444 7486; Fax: +1 401 444
8804; E-mail: [email protected]
Abstract: PURPOSE: To assess the willingness of adult primary-care
physicians to transfer young adults with special health care needs (YASHCN)
into their practices, and the relative impact of patient characteristics and
transition supports. METHODS: Survey of primary care internists and
family practitioners using randomized patient characteristics and transition
supports in clinical vignettes to assess physician willingness to accept a
YASHCN into their practice. RESULTS: 404 responses were received from 601
surveys (response rate 67%). Only 44% rated themselves "willing" or
"enthusiastic" to accept a YASHCN. Using four-way ANOVA testing, provider and
practice characteristics significantly associated with willingness to accept
included gender, years in practice, presence of YASHCN in current practice and
whether the practice was accepting new patients. Patient condition and
transition support significantly affected willingness to accept; training in
internal medicine versus family practice did not. CONCLUSION: Physicians providing primary care for adults express limited willingness to accept YASHCN
into their practices. Provider, practice and patient characteristics affected
willingness to accept. Although transition supports affected willingness to
accept, effects varied markedly across diagnoses and physician gender. Findings
have implications for patients and healthcare teams and policy planners.
Keywords: Health care transition, transition to adult care, adolescents with special health care needs
