Present Status of Countermeasures for Transitional Medicine on Pediatric Neurosurgery in Japan

[Purpose]Transitional medicine provides medical care and social support for the management of the pediatric‒onset diseases along with newly developing pathologies in each life stage for individual patients, to improve the prognosis of patients with such diseases. Since progress of transitional medicine in pediatric neurosurgery has not been evaluated in Japan, the current status of transitional medicine in this field was studied. [Methods]The Japanese Society for Pediatric Neurosurgery(JSPN)conducted a written questionnaire survey mainly within the hospitals of the JSPN councilors. [Results]The response rate was 90%. Institutions were categorized into the university hospital group (n=30, 28 university hospitals and 2 local core hospitals)and the pediatric hospital group(n=16, consisting of 13 free‒standing children’s hospitals, 3 pediatric medical units within a hospital and 2 children’s hospitals with close collaboration to an adjacent hospital). In both groups, there was no agreement on transitional medicine in the majority of(pediatric)neurosurgery departments and hospitals, but neurosurgeons in charge were often entrusted with the management of transition. During the past year, although the number of adult outpatients and inpatients in each hospital of the two groups varied greatly; there were no significantly different distribution patterns of these patient between the two groups. In their adulthood, patients were hospitalized in all the original hospitals in the university hospital group, but only in 82% of the hospitals in the children’s hospital group. The significantly lower rate in the children’s hospital group is presumed to be due to the admission restriction of adult patients in medical facilities constructed only for children. Although there were no such restrictions in the university hospital group, many hospitals in this group complained of shortage of human resources for pediatric neurosurgery. [Conclusion]To offer proper transitional medicine in pediatric neurosurgery, the university hospital group needs to secure necessary human resources, and improvements should be made in terms of admission restrictions of adult patients in children’s hospitals. To resolve these difficulties, it would be desirable to have pediatric medical units within a single hospital or a close collaboration of children’s hospitals with adjacent hospital facilities. JSPN should support these activities in all hospitals, and raise the issues of transitional medicine in pediatric neurosurgery to the Ministry of Health, Labor and Welfare and the general public. (Received December 16, 2019;accepted January 23, 2020)