In Reply: We agree with Drs Hunt and Sharma that significant changes occur when patients transition from pediatric to adult care. This transition can involve changes in location of care, the clinician caring for the patient, and the means to pay for medical care received.
In the 2008 National Health Interview Survey,1 29% of 18- to 24-year-olds were uninsured, the highest percentage of any age group. In addition, these young adults are least likely to have a usual place to go for medical care, when the emergency department is excluded as a usual site of care.1 Highlighting the importance of this transition period from a policy perspective, the president of the American Academy of Pediatrics specifically mentioned assessing the effectiveness of these transitions for children and youth with special health care needs in his testimony on comparative effectiveness research at a meeting of the National Advisory Committee for the Agency for Healthcare Research and Quality.2
Brousseau DC, Panepinto JA, Steiner CA. Transition From Pediatric to Adult Care for Patients With Sickle Cell Disease—Reply. JAMA. 2010;304(4):408-409. doi:10.1001/jama.2010.1027