scholarly journals P.210 Transitioning from Pediatric to Adult care: a Qualitative Study of Patients with Hydrocephalus and their Caregivers

2021 ◽  
Vol 48 (s3) ◽  
pp. S80-S80
Author(s):  
S Fouladirad ◽  
A Cheong ◽  
MS Tamber ◽  
A Singhal ◽  
PJ McDonald
Keyword(s):  
Health Care ◽  
Qualitative Research ◽  
Young Adults ◽  
Health Care Team ◽  
Structured Interviews ◽  
Health Care Environment ◽  
Adult Care ◽  
Care Environment ◽  
Pediatric Health Care ◽  
Anxiety And Fear

Background: Hydrocephalus is a common pediatric neurosurgical condition that requires lifelong care into adulthood. Significant gaps in care are thought to exist for youth transitioning to adult care, but little is known about how patients and their caregivers feel about the process. This study examines the perceptions of adolescents, young adults and caregivers when transitioning from pediatric to adult care at a single Canadian center. Methods: 40 patient/caregivers (7 adolescents, 13 young adults and 20 parents) treated at BC Children’s Hospital participated in semi-structured interviews using the qualitative research methodologies of grounded theory. Interviews were transcribed verbatim and coded, with common themes identified. Results: Four overarching themes relating to the process of transitioning from pediatric to adult care were identified: (1): Inadequacy of communication between pediatric and adult care teams and patients/caregivers; (2) Uncertainty relating to the prospect of life as an adult with hydrocephalus; (3) Anxiety and fear regarding navigating a new health care environment; and (4) sadness at the loss relationships with the pediatric health care team. Conclusions: We identified a general dissatisfaction with the transitioning process for hydrocephalus. Common themes and concerns identified may form the basis of an improved transitioning model for youth with hydrocephalus as they become adults.

The Conundrum of Charitability: Reassessing Tax Exemption For Hospitals

1990 ◽  
Vol 16 (3) ◽  
pp. 327-380
Author(s):  
David A. Hyman
Keyword(s):  
Health Care ◽  
Fundamental Problem ◽  
Health Care Environment ◽  
Care Environment ◽  
Sharp Focus ◽  
The Right ◽  
Do The Right Thing

Tax exemption is an ancient, honorable and expensive tradition. Tax exemption for hospitals is all of these three, but it also places in sharp focus a fundamental problem with tax exemption in general. Organizations can retain their tax exemption while changing circumstances or expectations undermine the rationale that led to the exemption in the first place. Hospitals are perhaps the best example of this problem. The dramatic changes in the health care environment have eliminated most of the characteristics of a hospital that originally persuaded the citizenry to grant it an exemption. Hospitals have entered into competition with tax-paying businesses, and have increasingly behaved like competitive actors. Such conduct may well be beneficial, but it does not follow that tax exemption is appropriate. Rather than an undifferentiated subsidy, a shift to focused goals will provide charitable hospitals with the opportunity and incentive to “do the right thing.”

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