Can their 18-year-olds make a doctor’s appointment? Half of parents say no

December 15, 2014 Volume 22 Issue 5
  • Two-thirds of parents believe teens should shift to adult-focused care by age 18; only one-third do so.
  • Less than one-half of parents of 18- to 19-year-olds believe their teens know how to make a doctor’s appointment.
  • Parents are least confident about their teens’ self-management related to knowing what their health insurance covers.

As teens get older, they shift from relying on their parents to being in charge of their own health care. With complex health care systems to navigate, parents naturally ask themselves: will my teen be ready to manage?

While parents are in an ideal position to judge whether their teens have the skills to manage their own health care, little is known about how parents view their teens’ readiness for taking responsibility in this arena. Health care experts refer to the process of shifting from child-focused care to adult-focused care for a teen or young adult as “transition,” which commonly occurs around age 18.

The C.S. Mott Children’s Hospital National Poll on Children’s Health asked a national sample of parents of adolescents and young adults aged 13-30 years about their perceptions of their adolescents’ / young adults’ abilities to manage their health care needs.

Teens and Their Health Care Self-Management Skills

Most parents (69%) believe adolescents should start seeing their adult-focused provider for primary care at age 18 (42%), or even at younger ages (27%). However, only about one-third (30%) of parents of 18- to 30-year-olds reported that their adolescents actually transferred to adult health care at age 18.

Explanations for delayed transitions to adult care may relate to parents’ perceptions of their teens’ lack of readiness to self-manage their care (Figure 1). While parents are largely confident in adolescents 16-17 years old and 18-19 years old  taking medications correctly, far fewer parents are confident in their teens’ abilities to manage several other aspects of their own care—such as knowing when to go to the emergency room or making an appointment—compared with parents of young adults 20-21 years old.

Implications

The results of this poll offer a national view of the perceptions of parents of adolescents and young adults when it comes to taking care of their own health care as independent individuals. While most parents generally agree that 18 years old is a reasonable age to transfer care from child-focused to adult-focused providers, that is not happening in practice. Instead, fewer parents perceive that their 16- to 17-year-olds and 18- to 19-year-olds have health self-management skills than do parents of 20- to 21-year-olds, for several skills other than taking medications. This suggests that adolescents and young adult children of these parents have not assumed primary responsibility for their health care needs, in many respects.

The take-home message from this poll is that a person’s age should not be the only factor, or even the major factor, in determining a person’s readiness to transfer from child-focused care to adult-focused care. Rather, before they  transition to an adult-focused health care system, adolescents may benefit from learning skills necessary to self-manage their health care needs. Their parents, and their health care providers, can promote adolescents’ greater roles in their care before age 18, in ways that help teens prepare to self-manage their future health care needs. In addition, working on skills in mid-teen years may help parents judge their teens’ readiness for independence when it comes to health and health care issues.

When it comes time to transition adolescents and young adults from child-focused to adult-centered care, there are no absolute rules. Recent guidelines from the American Academy of Pediatrics recommend that transition planning be tailored for each individual, and should include the development of skills necessary for a person to self-manage his own health care needs. The findings of this poll suggest that it may be helpful to start work on teens’ skills of self-managing their health earlier rather than later in adolescence.

Data Source

This report presents findings from a nationally representative household survey conducted exclusively by GfK Custom Research, LLC (GfK), for C.S. Mott Children’s Hospital via a method used in many published studies. The survey was administered in June 2014 to a randomly selected, stratified group of adults age 18 and older from GfK’s web-enabled KnowledgePanel® that closely resembles the U.S. population. Responses from parents with a child 13 to 30 (n=887) were used for this report. The sample was subsequently weighted to reflect population figures from the Census Bureau. The survey completion rate was 53% among the parent panel members contacted to participate. The margin of error is ± 5 to 9 percentage points and higher among subgroups.

C.S. Mott Children’s Hospital National Poll on Children’s Health
Director: Matthew M. Davis, MD, MAPP
Associate Director: Sarah J. Clark, MPH
Faculty Collaborator: Emily Fredericks, PhD
Manager & Editor: Dianne C. Singer, MPH
Data Analysts: Amilcar Matos-Moreno, MPH & Acham Gebremariam, MS
Web Editor: Anna Daly Kauffman, BA
Research Associate: Katrease Hale, MPH

Findings from the C.S. Mott Children's Hospital National Poll on Children's Health do not represent the opinions of the investigators or the opinions of the University of Michigan. The University of Michigan reserves all rights over this material.

SURVEY QUESTIONS FOR PARENTS WITH A CHILD AGE 13-17, PARENTS WITH ADULT CHILDREN 18-30 AND ADULTS AGE 18-30.

Q1.  On average, at what age do you think that a person should switch from a child-focused healthcare provider to an adult-focused provider for routine primary care?

Q2.  What type of healthcare provider does your child see for routine primary care?

  • Nurse practitioner
  • Family physician
  • Primary care pediatrician
  • Specialist pediatrician
  • Adolescent specialist
  • Internal medicine (adult) specialist
  • Obstetrician/gynecologist
  • Walk-in clinic provider
  • Other (please specify):

Q3. Please check the box below that best describes your child’s skill level in the following areas.
Does your child…

  No, he/she does not know how No, but he/she wants to learn No, but he/she is learning to do this Yes, he/she has started doing this Yes, he/she always does this when he/she needs to
Fill out family's medical history?          
Call the doctor's office to make an appointment?          
Fill out the medical history form, including a list of medicines and allergies?          
Take medications correctly and on his/her own?          
Know when to go to an emergency room or doctor's office?          
Know what his/her health insurance covers?          

THE NEXT SET OF QUESTIONS IS FOR PARENTS WITH A CHILD 18-30
Q4.  At what age did your child start having a different healthcare provider for routine primary care from when he/she was a child?

All information is the sole property of the University of Michigan C.S. Mott Children's Hospital National Poll on Children's Health. It can only be used if there is an acknowledgment that "The information came from, is copyright by and is owned by and belongs to the Regents of the University of Michigan and their C.S. Mott Children's Hospital National Poll on Children's Health. It cannot be republished or used in any format without prior written permission from the University."

C.S. Mott Children’s Hospital National Poll on Children’s Health
Director: Matthew M. Davis, MD, MAPP
Associate Director: Sarah J. Clark, MPH
Faculty Collaborator: Emily Fredericks, PhD
Manager & Editor: Dianne C. Singer, MPH
Data Analysts: Amilcar Matos-Moreno, MPH & Acham Gebremariam, MS
Web Editor: Anna Daly Kauffman, BA
Research Associate: Katrease Hale, MPH

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Figure 1: Parent's perception of their adolescent's/young adult's ability to manage health care needs

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