Statement

Pediatricians mean Likert rating

Internists mean Likert rating

P Value

I. Patient and family involvement

1.             1. Patients undergoing transition often have difficulty trusting the new physician.

3.79

3.15

^*0.0178

2.             2. Willingness and readiness of the patient and family are important factors for transition.

4.75

4.69

0.6532

3.             3. The patient and family’s attachment and familiarity with the pediatrician usually hinder a smooth transition to adult care.

3.79

3.42

0.1798

4.             4. Patient awareness and communication with the family regarding the transition process are both necessary.

4.79

4.73

0.618

5.             5. Family involvement and cooperation in the decision making play important role during transition

4.75

4.69

0.6532

II. Clinical/Medical

1.             1. Adjustment of medicine dosage from pediatrics to adult can be difficult for the new physician.

2.67

2.73

0.787

2.             2. There should be formal endorsement between internist and pediatrician.

4.50

4.50

0.9111

3.             3. Proper referral and turnover of records by the pediatrician to the internist especially in long standing cases play a significant role in transition success.

4.42

4.42

0.9306

4.             4. There should be a clinical pathway to reconcile differences between pediatric and adult management guidelines during transition.

4.42

4.12

0.4979

5.             5. Patient records should be stored properly for easy retrieval and endorsement

4.67

4.65

0.9246

III. Healthcare provider

1.             1. The choice of the receiving doctor should be a joint decision between the physician and the patient’s family.

4.29

4.50

0.2977

2.             2. Prior to referral, competency and approach of the receiving physician are important considerations.

4.71

4.46

0.1194

3. Personal endorsement is essential during transition.

4.29

4.00

0.1994

4.             4. Transitioning of patients from pediatrics to adult care should start early and must be gradual.

4.17

3.73

0.0812

5.             5. Communication and coordination between the pediatrician and internist should be continuous during transition process.

4.42

4.23

0.2918

IV. Institutional coordination process

1.             1. There should be a hospital protocol and uniform guidelines in health care transition.

4.33

3.96

0.1807

2.             2. There should be interhospital coordination and referral system guideline for the transfer of care of patients.

4.29

4.15

0.6783

3.             3. Residents, fellows and consultants should be trained on proper referral system and transition process.

4.71

4.23

^*0.0308

4.             4. Complete electronic records should be made available to the transition team

4.13

3.96

0.4494

5.             5. A transition clinic/program should be established in all hospitals.

4.21

3.73

0.0737

V. Psychosocial

1.             1. Patient anxiety and readiness should be addressed by both health care providers (pediatrician/internist) for a smooth transition.

4.67

4.31

0.0209

2.             2. The financial capability of the family is a primary concern during transition.

4.08

3.46

0.0152

3.             3. A patient for transition should undergo psychological evaluation.

3.38

3.23

0.6265

4.             4. Transition clinic must be conducive in establishing patient rapport and confidence to the new doctor.

4.46

4.15

0.1411

5.             5. The transition process should be able to address the psychological and emotional impact on the patient.

4.50

4.04

0.0174