One of the growing challenges in today's health care system is the increase in the number of childhood illnesses that are survived and the number of adults who continue to live with the disease. There is a subset of the pediatric hospital population that is older than 18 years, often because of the nature of their illness and the physicians who have cared for them. It has been estimated that 2.1% of discharges from pediatric hospitals were for patients between 21 and 64 years old. To date, there are little data on how best to care for adult patients in a pediatric hospital.
We set out to describe a unique and hopefully beneficial model that takes into account both the patients’ disease as well as their age. The combined internal medicine–pediatric training program at the Ohio State University College of Medicine and Nationwide Children's Hospital has been in existence for 25 years. Before implementation of the model, a patient older than 18 years who was hospitalized at Nationwide Children's hospital was cared for by the pediatrician. If a complication aros,e an individual Med‐Peds faculty or resident would be called on to provide assistance. In 2006 we set out to formalize the process and pool the resources of the Divisions of Hospital Medicine at both Nationwide Children's Hospital and the Ohio State University hospitals.
The hospitalist program at Ohio State University was created in July 2003 and at Nationwide Children's Hospital in 2006. Currently there are 11 dual board‐certified Med‐Peds trained physicians between the divisions. We started with a 24‐hour/ day pager covered by a Med‐Peds‐trained hospitalist that allowed for a formal general internal medicine consult or help in initiating a transfer to the adult hospital if appropriate. Currently, we provide in‐hospital daytime consultative/ primary coverage for adult inpatients at Nationwide Children's Hospital and continued 24‐hour pager coverage. As our experience grows, we have seen an increase in the variety of services. Initially, the consults were generated by the neurosurgery and cardiovascular services; we now see a wide range of patients, including adults with cerebral palsy, mental retardation, adolescent addiction, and other chronic childhood illnesses.
Our numbers to date do not allow us to comment on length of stay, morbidity–mortality, or other metrics of quality care. As the number of chronic childhood diseases treated successfully increases, we believe that the continued collaboration will improve patient care and comfort level and provide a unique opportunity for faculty members who are interested in both the pediatric and the adult hospitalized patient.
N. J. O’Dorisio ‐ none; E. R. Schumacher ‐ none; S. A. Holliday ‐ none
To cite this abstract:O’Dorisio N, Schumacher E, Holliday S. A Novel Approach to the Adult Pediatric Patient. Abstract published at Hospital Medicine 2011, May 10-13, Dallas, Texas. Abstract 1009. Journal of Hospital Medicine. 2011; 6 (suppl 2). https://www.shmabstracts.com/abstract/a-novel-approach-to-the-adult-pediatric-patient/. Accessed March 31, 2020.