Transition from paediatric to adult health care in Poland – current problems and future challenges. Analysis of issues faced by patients with inborn errors of immunity

Abstract

The health care system in Poland provides treatment for patients up to 18 years of age in paediatric health care facilities, whereas adult patients are treated in specialist health care facilities for adults. A critical moment for the continuity of permanent treatment for all people with chronic disease is the transition from paediatric care to adult care. Organisational, psychological, and social problems can disrupt this process, posing the risk of health deterioration, and in extreme cases, discontinuation of therapy and premature mortality among young adults. In Poland, there is no universal, coordinated, efficient, and successful model for patient transition. This article highlights potential factors contributing to the lack of fluidity in the transition process and the associated risks. Examples of models ensuring optimal transition of a paediatric patient to adult care are also presented. It seems that creating systematic, uniform patient transfer programmes is the only way to eliminate potential threats. The crucial elements in this process are postulated to include: 1) advance planning of the transition process, 2) efficient transfer of information about the patient’s condition and treatment between paediatric and adult centres, 3) patient awareness of their new role in the decision-making process. The article focus on patients with inborn errors of immunity, highlighting the current experience and potential reasons for failures in the patient transition proces