Adolescents with chronic disease. Are they receiving comprehensive health care?

A survey of adolescents with a chronic disease attending six specialty clinics was conducted to determine the sources of their primary health care and to estimate the extent of unmet health needs. Sixty-one patients completed a self-administered questionnaire. Forty percent had no source of primary care other than the subspecialty clinic treating their chronic condition. Seventy-eight percent regarded the subspecialist as their "personal" physician, although only 27% actually spoke to this physician about their general health needs. For 44% general health needs were not being met. These findings suggest that these adolescents expect the subspecialty clinic to provide primary care; yet they receive, at best, fragmented health care. This situation could be improved by a decision on the part of the subspecialty to restrict its role to providing only specific specialty care or to coordinate overall care.