Transition backslide: Patterns of patient reengagement with a pediatric health system after a coordinated transfer to adult care.

Background: Transition to adult healthcare systems is a complex process for young adults with chronic diseases and/or developmental disabilities. Our pediatric health system (PHS) created a referral-based multidisciplinary transition team (MTT) to support complex transfers, yet some patients continued to reengage post-transfer of care. We aimed to identify these patients, characterize patient-initiated reengagement trends, and assess factors associated with reengagement. Methods: We conducted a retrospective observational study of patients referred to the MTT between July 1, 2017, and June 30, 2019, who had transitioned from pediatric to adult care providers by June 30, 2020. Data were extracted from the MTT clinical database and electronic health records. Results: Of 73 eligible participants, 63 (86 %) reengaged with the PHS at large after transfer of care, accounting for 540 separate encounters. Reengagement encounters were categorized as anticipated (56 %, n = 302), unanticipated (33 %, n = 181), or specifically with the MTT (11 %, n = 57). Average time to first reengagement encounter differed significantly across groups ( Conclusion: Reengagement with PHS post-transfer of care was common, even among patients transitioning with structured support from our MTT. These findings underscore the need for continued PHS support even after transferring to adult healthcare systems.