Measuring the “triple aim” in transition care: a systematic review
Abstract
BACKGROUND AND OBJECTIVES: Without adequate support, adolescents transitioning from the pediatric to the adult health care system are at increased risk for poor health outcomes. Numerous interventions attempt to improve this transition, yet few comprehensively evaluate efficacy. To advance evaluation methods and ultimately the quality of transition services, it is necessary to understand the current state of health care transition measurement. This study examines and categorizes transition measures by using the "Triple Aim" framework of experience of care, population health, and cost of care. METHODS: Ovid Medline and the Cumulative Index to Nursing and Allied Health Literature were searched for articles published between 1995 and 2013. Two reviewers independently screened studies and included those that evaluated the impact of a health care transition intervention. Measures were subsequently classified according to population health, experience of care, and costs of care. RESULTS: Of the 2282 studies initially identified, 33 met inclusion criteria. Population health measures were used in 27 studies, with disease-specific measures collected most frequently. Fifteen studies measured cost, most often service utilization. Eight studies measured experience of care, with satisfaction assessed most commonly. Only 3 studies examined all 3 domains of the "Triple Aim." Transition interventions described in the gray literature were not reviewed. CONCLUSIONS: Transition programs are inconsistently evaluated in terms of their impact on population health, patient experience, and cost. To demonstrate improvement in the transition from pediatric to adult health care, a more robust and consistent set of measures is needed.
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There is a lack of consistent measures of what constitutes transition success.
“The identification of barriers to successful transition is challenging due to a lack of consistent measures of what constitutes transition success.531,534”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [534]
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- Authors
- Prior, M., McManus, M., White, P., & Davidson, L.
- Affiliations
- Georgetown University (US)
- The National Alliance to Advance Adolescent Health, Washington, District of Columbia; and
- ORCID
- White, Patience
- Venue
- PEDIATRICS
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2014-12-01
- Volume
- 134
- Issue
- 6
- Pages
- e1648-e1661
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W1967405980
- Cited by
- 176
- References
- 14
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 9 · 2023: 16 · 2022: 20 · 2021: 11 · 2020: 17 · 2019: 16 · 2018: 22 · 2017: 21 · 2016: 16 · 2015: 14
- FWCI
- 3.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Institute for Health Care Improvement
- Agency for Healthcare Research and Quality
- U.S. Public Health Service (U39MC25729)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
- Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
- Keywords
- Triple Aim, care transitions, adolescents, outcome measurement, population health, patient experience, health care costs, service utilization, patient satisfaction, transition interventions
- MeSH terms
- Adolescent, Adult, Chronic Disease, Cross-Cultural Comparison, Health Resources, Health Services Research, Health Status Indicators, Humans, Quality of Health Care, Socioeconomic Factors, Health Care Costs, Patient Satisfaction, Patient-Centered Care, Young Adult, Quality Improvement, Transition to Adult Care
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