Redesigning Care of Hospitalized Young Adults With Chronic Childhood-Onset Disease.


Background Young adults with chronic childhood-onset disease (CCOD) are routinely admitted to internal medicine hospitalist services, yet most lack transition preparation to adult care. Providers and patients feel the strain of admissions to adult services in part due to their medical and social complexity. Methods We performed a descriptive study of a care redesign project for young adults with CCOD hospitalized at a large, tertiary care academic hospital. We describe the process of implementation of the Med-Peds (MP) service line and characterize patients cared for by the service. We measured and analyzed patient demographics, process implementation, healthcare screening, and healthcare utilization data. Results During the 16 months of the study period, 254 patients were cared for by the MP service line, accounting for 385 hospitalizations. The most common CCODs were sickle cell disease (22.4%) and type 1 diabetes (14.6%). The majority (76%) of patients completed transition readiness assessment, and 38.6% completed social determinant of health (SDH) screening during their admission. Patients had high prevalence of SDH with 66.7% having an unmet social need. The average length of stay was 6.6 days and the average 30-day readmission rate was 20.0%. Conclusions There is opportunity to redesign the inpatient care of young adult patients with CCOD. The MP service line is a care model that can be integrated into existing hospital medicine teams with MP physicians. Hospitals should consider redesigning care for young adults with CCOD to meet the transitional and social needs unique to this patient population.





Published Version (Please cite this version)


Publication Info

Feeney, Colby D, Alyssa Platt, Jesse Rhodes, Yasmin Marcantonio, Sonya Patel-Nguyen, Tyler White, Jonathan A Wilson, Jane Pendergast, et al. (2022). Redesigning Care of Hospitalized Young Adults With Chronic Childhood-Onset Disease. Cureus, 14(8). p. e27898. 10.7759/cureus.27898 Retrieved from

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Colby Danielle Feeney

Assistant Professor of Medicine

Alyssa Platt

Biostatistician III

Education: Masters Degree, Applied Economics.  Duke University. 2007
Bachelors Degree, Economics and Mathematics.  University of North Carolina at Greensboro

Overview: Alyssa has ongoing collaborations with faculty from Duke Global Health Institute, Hospital Medicine, and Center for Aging. She has experience spanning the entire research cycle from grant development and research design, to primary data (or secondary data analysis), and publication of research findings. Alyssa has an MA in applied economics from Duke University and has a range of experience in the fields of health economics, health behaviors and health outcomes, including physician behavior, obesity and physical activity, infectious diseases, and childhood hearing loss. Special areas of expertise are in pilot/feasibility studies, cluster-randomized trials, electronic health records, and health economics.


Sonya Patel-Nguyen

Assistant Professor of Medicine

David Yung Ming

Associate Professor of Pediatrics

I am a med-peds hospitalist and researcher with interests in improving systems of care of patients with complex health needs. My research focus areas include implementation science, population health sciences, community-engaged research, and digital health. My vision is to design, implement, evaluate, and scale programs and interventions that will simplify the delivery of complex care. By doing so, we can equitably improve the health outcomes that matter most to children and adults with complex health needs and their families.

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