Transition to Adult Health Care for Youth with Disabilities: Implications for Health Policy

This dissertation contains three papers, each on a different aspect of transition to adult healthcare for youth with disabilities. The overall aim of this dissertation research was to identify system level health care transition strategies for youth with disabilities, determine the amount and degree to which Canadian jurisdictions reflect those transition strategies in government posted documents and policy, and to understand the current status of national healthcare transition policy in Canada, the UK, and Australia. The first paper describes the results of a scoping review identifying system level strategies for policy addressing continuity of care and care transitions to adult health care for youth with disabilities. The second paper is an analysis of the match of those system level strategies to current Canadian provincial and territorial government documents and policies related to transitions to adult health care for youth with disabilities. The third paper is an analysis of international alignment and variance between Canada, the UK and Australia with respect to transitions related government policies and direction. Collectively, this dissertation research found that system level strategies in support of continuity of care and transitions to adult health care for youth with disabilities exist. The challenge of achieving effective health care transition for youth with disabilities moving from the paediatric to adult health systems is identified as an area of importance by paediatric and adult health care service providers, clients and families. However, there are considerable variances in government attention and action in addressing the issue of health care transition, and thus, variability in existing policy inclusive of transition strategies across Canada, the UK and Australia. The combined findings of these studies suggest that health system strengthening, in the area of transitions to adult health care for youth with disabilities, should be supported through health policy implementation and/or change. Policy addressing transitions to adult health care for youth with disability could drive change through: (a) bringing awareness to the issue; (b) mitigation of client-specific and system wide impacts of ineffective health care transition; and through (c) the promotion of accountability mechanisms for effective continuity of care for youth with disabilities.Ph.D