Policy on Transition of Care for Youth with Special Health Care Needs

The Directorate General of Health Services (DGHS) has published its Policy on Transition of Care (ToC) for Youth with Special Health Care Needs (YSHCN). This policy was published on March 11, 2024.

Transition of Care (ToC) is emerging as a critical component of healthcare due to significant advancements in medical treatment, leading to improved survival rates among patients with chronic diseases originating in childhood. In many public sector hospitals, adolescents and young adults are often directed to medical outpatient departments (OPDs) rather than pediatric OPDs once they surpass the age limit for pediatric services. While this approach is suitable for healthy individuals seeking treatment for common illnesses, it fails to address the needs of Youth with Special Health Care Needs (YSHCN).

YSHCN are individuals with chronic physical, developmental, behavioral, or emotional conditions requiring specialized health services beyond what is typically needed for children. Unfortunately, there are no established guidelines for transitioning such patients from pediatric to adult care systems in India. To address this gap, guidelines for transitioning care have been introduced to facilitate the seamless transfer of adolescent patients with chronic illnesses into the adult healthcare system.

Transition of Care involves a purposeful, planned process that addresses the medical, psychosocial, educational, and vocational needs of adolescents and young adults with chronic conditions as they transition from child-centered to adult-oriented healthcare systems. The goal is to ensure uninterrupted, high-quality healthcare services that support the individual’s development and potential throughout their transition to adulthood.

Data from the US Department of Health and Human Services reveals that nearly 31% of adolescents have moderate to severe chronic illnesses, underscoring the importance of tailored healthcare services for this demographic. Similarly, data from India highlights the prevalence of chronic conditions such as thalassemia, epilepsy, diabetes, and asthma among adolescents, emphasizing the need for structured transition programs.

While policies and guidelines for ToC have been established in developed countries for several decades, India is still in the nascent stages of implementing such programs. Proper ToC is essential to ensure that adolescents with chronic illnesses receive specialized care from healthcare providers experienced in adult medicine, thereby maximizing their lifelong functioning and potential.

Moreover, proper ToC reduces the risk of treatment non-adherence, prevents complications associated with chronic diseases, and enhances patient satisfaction and self-care capabilities.