Transitions of Care for Healthy Young Adults

Promoting Primary Care and Preventive Health

Laurie Graves, MD; Shannon Leung, MD; Prashant Raghavendran, DO; Sarah Mennito, MD, MSCR


South Med J. 2019;112(9):497-499. 

In This Article

Abstract and Introduction


The transition of care between pediatric and adult medicine is a challenging time for patients and physicians. This longitudinal process encompasses much more than the physical transfer of a patient between providers. Established transition of care processes and literature exist for many chronic disease populations, but little focus has been directed toward the transition of care and the delivery of preventive medicine for healthy young adult patients. The 18- to 30-year-old age group is a heterogenous population that often engages in high-risk behaviors and has high rates of preventable morbidity and mortality. A significant number of these patients do not receive routine primary care and are high users of costly emergency services. Without a continuous source of care, many young adults do not receive age-appropriate screening or preventive health guidance. Structured transition practices improve outcomes in the chronic disease population, and anticipatory guidance has a positive effect on patient lifestyle modification. Adult providers should use these practices to ensure the successful integration of healthy young adult patients into an adult medical home. By establishing an ongoing source of preventive care, providers could reduce morbidity and mortality in this vulnerable population.


Providing routine care for young adults without chronic medical problems can feel superfluous in a society with an aging and increasingly chronically ill population. Furthermore, the period of emerging adulthood is a challenging time for patients in all aspects of life, including health care. This population has one of the highest rates of emergency department use and one of the lowest rates of primary care utilization.[1] Although the majority of adolescents and young adults (AYA) do not have chronic medical needs, young adult patients experience high rates of preventable morbidity and mortality as a result of high-risk behaviors and can develop chronic diseases that may go undetected or untreated because of a lack of care. Significant research has examined the transition needs of those with chronic conditions; however, scant literature examines transitioning healthier young adults, who are frequently lost to care during this time. Pediatric and adult primary care providers have unique roles in transitional care for this population to ensure continuous preventive care.

This Perspective emphasizes the importance of transitioning young adults without complex care needs into adult primary care, highlighting the role of the medical home and appropriate anticipatory guidance (AG), to keep these vulnerable patients engaged with providers. Through such engagement, the medical community can have large effects on preventable illness that may result from gaps in care during the transition period.