Failure to launch: Pediatric colorectal surgery center utilization by patients over 18 years of age.

PURPOSE: As patients with childhood colorectal diseases transition into adulthood, many continue to seek care at pediatric colorectal centers rather than transitioning to adult hospital systems. The growing number of these patients places increasing demands on pediatric resources, potentially diverting care from younger patients. This study aimed to assess the utilization of a pediatric colorectal center by patients aged 18 and older who have not successfully transitioned to an adult healthcare system.

METHODS

A retrospective review was conducted on resource utilization at our pediatric colorectal center for patients aged 18 and older from August 2017 to March 2024. Patients with less than one year of follow-up after turning 18 were excluded.

RESULTS

116 adult patients met the inclusion criteria, ranging in age from 19 to 27 years (mean 20.9). The cohort included 54 (46.6 %) males and 62 (53.4 %) females, with a median follow-up of 30.5 months (range 12-100 months). Only 38 patients (33 %) successfully transitioned to adult care. In comparison, 78 patients (67 %) continued to rely on the pediatric system, generating significant resource utilization: 180 emergency room visits, 243 hospital admissions, 1486 clinic visits, 230 surgeries, 18,373 phone calls/messages, and 1,159 radiologic studies.

CONCLUSIONS

Our findings highlight the substantial ongoing reliance of adult patients on pediatric colorectal centers, emphasizing the need for structured transition to adult care programs. Addressing these challenges is essential for ensuring the well-being of adult patients while optimizing resource allocation within pediatric centers.

LEVEL OF EVIDENCE: Level IV (Case Series).