Age limits and transition of health care in pediatric emergency medicine


Age limits and transition of health care in pediatric emergency medicine


Dobson JV; Bryce L; Glaeser PW; Losek JD


Pediatric Emergency Care




Child; Female; Humans; Male; United States; Pregnancy; Pediatrics; Adult; Data Collection; Age Factors; Cystic Fibrosis; Hospitals; Emergency Medicine; Organizational Policy; Emergency Service; adolescent; Adolescent Transitions; Pregnancy in Adolescence; Pediatric/statistics & numerical data; Hospital/statistics & numerical data; General/statistics & numerical data


OBJECTIVE: To describe the practice reported by pediatric emergency department (PED) medical directors regarding age limits and transition of health care in their emergency departments and institutions. METHODS: A 28-question survey was sent by e-mail to 116 PED medical directors. Descriptive statistics were used to report results; chi tests were used for comparing categorical data. RESULTS: The survey was completed by 73 PED medical directors (63%). Age-limit policies were present in 58 (79%) of the PEDs, and 56 reported a specific age. The 18th and 21st birthdays were the most common specific ages cited. Thirty-six PEDs (64%) had an age limit of younger than 21 years. Pediatric emergency departments with age limits of 21 years or older versus younger than 21 years had a significantly higher rate of being associated with freestanding children's hospitals (P = 0.037). Appropriate exceptions to the age-limit policy included patients both over and under the age limit. The most common overage limit exception was cystic fibrosis, and the most common underage limit exception was teenage pregnancy. Thirteen PED medical directors (18%) were aware of a transition-of-care (pediatric to adult care provider) policy or work group at their institution, and 47 (64%) thought that such a work group would be valuable to addressing transition-of-care issues. CONCLUSION: In pediatric emergency medicine, the age of transition from pediatric to adult emergency care providers is variable both between and within institutions. Most PEDs have age limits of younger than 21 years. Most PED medical directors support a multidisciplinary work group or committee as a method of addressing transition of care. Known barriers to transition of care previously reported in the literature are reviewed.


Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).


Journal Article

Citation List Month



Dobson JV; Bryce L; Glaeser PW; Losek JD, “Age limits and transition of health care in pediatric emergency medicine,” Pediatric Palliative Care Library, accessed September 30, 2023,