Current practice and barriers for transition of care (TOC) in pediatric surgery: perspectives of adult surgeons from different subspecialties.

Abstract

Introduction: The advancements in neonatal resuscitation and surgical care have enabled children with congenital abnormalities to receive corrective surgeries and achieve lifespans well into adulthood. These patients may require long-term follow-up as they continue to have risks of developing sequelae from their original diseases or surgical interventions.

Purpose: This study aimed to investigate the current practice and barriers to the transition of care (TOC) from the perspectives of adult surgeons.

Methods: A cross-sectional study was conducted with purposive sampling of adult surgeons from different subspecialties. An online self-administered questionnaire was distributed.

Results: There were 60 respondents. 62% of the respondents had experience managing referrals for continuation of care or complications in patients with congenital abnormalities. 38% of the respondents believed that TOC should be implemented when patients reached ages 17-18 years. 93% of the respondents agreed that a proper TOC model would greatly benefit patient care, and 97% asserted the need to develop TOC pathways in Malaysia. The absence of a proper guideline was the greatest barrier to a smooth TOC.

Conclusion: This study offered insights into the obstacles to TOC based on the perspectives and experiences of adult surgeons who participated. While not exhaustive, our study provided a better understanding of the challenges in developing the appropriate referral pathways for the continued care of these patients.