A novel score for transition success of pediatric rheumatology patients

Health Care Transitions Pub Date : 2026-01-01 Epub Date: 2026-02-24 DOI:10.1016/j.hctj.2026.100130

Kyla Blasingame , David McDonald , Miriah Gillispie-Taylor , Tiphanie P. Vogel

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Abstract

Background

Success of transition from pediatric to adult care depends on many factors. Various scores for transition readiness have been developed, but few patient-level transition success scores exist. Without such a metric, it is difficult to assess the impact of programmatic interventions to improve the process of healthcare transition. We created a novel transition success score for pediatric rheumatology patients.

Methods

Pediatric rheumatologists consulted the literature and adolescent health experts. Four components were included in the final score: attending a first adult appointment in the time frame designated by the pediatric rheumatologist (component 1), refilling medications with the adult provider within 3 months of the first adult appointment (component 2), no rheumatology-related emergency department visits in the first year after transition (component 3), and attending a second adult appointment (component 4). Scores were determined via retrospective electronic medical record (EMR) review. Each component was weighted as one-quarter of the total transition success score.

Results

From 2017–2024, we identified 357 patients with a final visit to pediatric rheumatology using a combination of direct provider notification of transition and EMR review. Of those, EMR records were available to score transition success for 198 patients. Optimal transition success (ie achievement of all 4 components of successful transition) was accomplished by 72/198 (36 %) patients; 77/198 (39 %) patients scored 75 %. Only 3 patients (1.5 %) scored 0 %. When considered by component, 113 patients (57 %) met component 1, 150 (76 %) met component 2, 165 (83 %) met component 3, and 159 (80 %) met component 4. We were unable to document attendance at a second adult rheumatology appointment for a surprising 20 % (39/198) of transitioned patients.

Conclusions

We have developed a transition success score and applied it to an initial cohort of patients who transitioned from our pediatric rheumatology clinic. Although 149/198 patients (75 %) fulfilled 3 or 4 out of 4 components of successful transition, we have identified clear opportunities for improvement. Our next steps include evaluating components of our transition program, such as patient self-reported transition readiness or receipt of a transition summary letter, against the transition success score to better understand which factors predict successful transition.

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儿童风湿病患者过渡成功的新评分。

背景：从儿科到成人护理的成功过渡取决于许多因素。已经开发了各种转换准备评分，但很少有患者级别的转换成功评分。如果没有这样一个指标，就很难评估程序性干预措施对改善医疗保健转型过程的影响。我们为儿童风湿病患者创建了一个新的过渡成功评分。方法：儿科风湿病学家查阅文献和青少年健康专家。最终评分包括四个组成部分：在儿科风湿病专家指定的时间框架内参加第一次成人预约（组成部分1），在第一次成人预约后3个月内与成人提供者补充药物（组成部分2），在转换后的第一年没有风湿病相关的急诊科就诊（组成部分3），以及参加第二次成人预约（组成部分4）。通过回顾性电子病历（EMR）检查确定评分。每个组成部分被加权为总转换成功得分的四分之一。结果：从2017-2024年，我们确定了357例使用直接提供者转换通知和EMR审查组合进行儿科风湿病最终就诊的患者。其中，EMR记录可用于评估198名患者的过渡成功。72/198（36% %）患者实现了最佳过渡成功（即成功过渡的所有4个组成部分的实现）；198例患者中有77例（39 %）得分为75 %。只有3例患者（1.5 %）得分为0 %。当按成分考虑时，113例患者（57 %）符合成分1,150例（76 %）符合成分2,165例（83 %）符合成分3,159例（80 %）符合成分4。令人惊讶的是，我们无法记录20% %（39/198）的转换患者在第二次成人风湿病预约时的出勤情况。结论：我们已经开发了一个过渡成功评分，并将其应用于从我们的儿科风湿病诊所过渡的初始队列患者。尽管149/198例患者（75% %）完成了成功过渡的4个组成部分中的3或4个，但我们已经确定了明显的改善机会。我们接下来的步骤包括评估我们的过渡计划的组成部分，如患者自我报告的过渡准备或收到过渡总结信，对比过渡成功得分，以更好地了解哪些因素预测成功的过渡。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Health Care Transitions

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