The Transition of Adolescents with Chronic Health Conditions from Paediatric to Adult Services (original) (raw)
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Comparative Healthcare: Child Health
Unlike India Australia boasts many community services for children from families with complex health problems. Practitioners from India report that their private health system is among the best in the world and that the training, experience and quality of Indian doctors attract private patients from across the globe. On the other hand for many Indians their local health system is not well resourced as is illustrated in the response to these case scenarios. The coverage of organized immunisation program can be limited in some areas; therefore infectious disease is a far greater problem than it is in Australia. In India liberal controls over the sale of many drugs has resulted in widespread abuse of antibiotics and NSAIDs. The lack of electricity in rural areas precludes the storage of insulin and sterile injecting equipment which undermines the quality of diabetic care. On the other hand most Australians benefit from greater government expenditure on health. The welfare system is much more equipped to support parents from underpriviledge areas. Many schools will accept children with intellectual or physical challenges into mainstream classes and can sometimes be financially supported to have a teacher’s assistant for the child. Two groups of Australians need extra support: migrants who may not speak English or know how to access statutory services and Aboriginal people for whom language, lack of social supports or remoteness from health care underscores inequity.
BMC Public Health, 2016
Background: There is a significant body of evidence that highlights the importance of addressing the social determinants of child and youth health. In order to tackle health inequities Australian governments are being called upon to take action in this area at a policy level. Recent research suggests that the health and well-being of children and youth in Australia is 'middle of the road' when compared to other OECD countries. To date, there have been no systematic analyses of Australian child/youth health policies with a social determinants and health equity focus and this study aimed to contribute to addressing this gap. Methods: Document analysis of seventeen strategic level child/youth health policies across Australia used an a priori coding framework specifically developed to assess the extent to which health departments address the social determinants of child/youth health and health equity. Policies were selected from a review of all federal and state/territory strategic health department policies dated between 2008 and 2013. They were included if the title of the policy addressed children, youth, paediatric health or families directly. We also included whole of government policies that addressed child/youth health issues and linked to the health department, and health promotion policies with a chapter or extensive section dedicated to children. Results: Australian child/youth health policies address health inequities to some extent, with the best examples in Aboriginal or child protection policies, and whole of government policies. However, action on the social determinants of child/youth health was limited. Whilst all policies acknowledge the SDH, strategies were predominantly about improving health services delivery or access to health services. With some exceptions, the policies that appeared to address important SDH, such as early childhood development and healthy settings, often took a narrow view of the evidence and drifted back to focus on the individual. Conclusions: This research highlights that policy action on the social determinants of child/youth health in Australia is limited and that a more balanced approach to reducing health inequities is needed, moving away from a dominant medical or behavioural approach, to address the structural determinants of child/youth health.
BMJ Open, 2021
Introduction One-third of Australia's Aboriginal and Torres Strait Islander population are adolescents. Recent data highlight their health needs are substantial and poorly met by existing services. To design effective models of primary healthcare, we need to understand the enablers and barriers to care for Aboriginal and Torres Strait Islander adolescents, the focus of this study. Methods and analysis This protocol was codesigned with Apunipima Cape York Health Council that supports the delivery of primary healthcare for 11 communities in Far North Queensland. We framed our study around the WHO global standards for high-quality health services for adolescents, adding an additional standard around culturally safe care. The study is participatory and mixed methods in design and builds on the recommended WHO assessment tools. Formative qualitative research with young people and their communities (exploring concepts in the WHO recommended quantitative surveys) seeks to understand demand-side enablers and barriers to care, as well as preferences for an enhanced response. Supply-side enablers and barriers will be explored through: a retrospective audit of clinic data (to identify current reasons for access and what can be strengthened); an objective assessment of the adolescent friendliness of clinical spaces; anonymous feedback from adolescent clients around quality of care received and what can be improved; and surveys and qualitative interviews with health providers to understand their perspectives and needs to provide enhanced care. This codesigned project has been approved by Apunipima Cape York Health Council and Far North Queensland Human Research Ethics Committee. Dissemination and implications The findings from this project will inform a codesigned accessible and responsive model of primary healthcare for Aboriginal and Torres Strait Islander adolescents.
Challenges in health and health care for Australia
The Medical journal of Australia, 2007
The next Australian Government will confront major challenges in the funding and delivery of health care. These challenges derive from: Changes in demography and disease patterns as the population ages, and the burden of chronic illness grows; Increasing costs of medical advances and the need to ensure that there are comprehensive, efficient and transparent processes for assessing health technologies; Problems with health workforce supply and distribution; Persistent concerns about the quality and safety of health services; Uncertainty about how best to balance public and private sectors in the provision and funding of health services; Recognition that we must invest more in the health of our children; The role of urban planning in creating healthy and sustainable communities; and Understanding that achieving equity in health, especially for Indigenous Australians, requires more than just providing health care services. The search for effective and lasting solutions will require a c...
Transition health services for youth with disabilities: A global perspective
Journal of Adolescent Health, 1995
The need for young people with chronic illness and disability to transfer from pediatric to adult care is being increasingly recognized in Australia. The challenge posed to the health care system by such a cohort of young people surviving into adult life has been recognized as part of the development of a national policy in Australia for the health of children and young people. The development of models for transition programs in Australia has been discussed in the literature (1,2) and as part of national meetings of The Royal Australian College of Physicians and specialist societies. In addition, patient support groups have been active in advocating for the development of more comprehensive transition programs for young people with chronic illness and disability. A national, universal health insurance strategy has been in operation for over a decade and is clearly a permanent fixture in the Australian health policy
2021
Introduction More than 10% of adolescents live with a chronic disease or disability that requires regular medical follow-up as they mature into adulthood. During the first 2 years after adolescents with chronic conditions are transferred to adult hospitals, non-adherence rates approach 70% and emergency visits and hospitalisation rates significantly increase. The purpose of the Bridge study is to prospectively examine associations of transition readiness and care experiences with transition success: young patients’ health, health-related quality of life (HRQoL) and adherence to medical appointments as well as costs of care. In addition, we will track patients’ growing independence and educational and employment pathways during the transition process. Methods and analysis Bridge is an international, prospective, observational cohort study. Study participants are adolescents with a chronic health condition or disability and their parents/guardians who attended the New Children’s Hospi...