The second edition of the National Conference on “Transition of Pediatric Patients to Adult Health Services” took place in Bucharest, Romania, drawing healthcare professionals, policymakers, and patient advocates to address one of the most critical yet underdiscussed challenges in modern medicine: ensuring seamless, coordinated care for young people with chronic conditions as they move from pediatric to adult healthcare systems. Organized by MedicalManager.ro, the conference built on the momentum of its inaugural edition, aiming to translate growing awareness into actionable strategies for clinics, hospitals, and health authorities across the country.
Transition care — defined as the purposeful, planned movement of adolescents and young adults with chronic physical and medical conditions from child-centered to adult-oriented healthcare systems — remains a persistent gap in healthcare delivery worldwide. In Romania, as in many Central and Eastern European nations, fragmented systems, lack of standardized protocols, and insufficient training for adult providers on pediatric-onset conditions often result in poor outcomes, increased hospitalizations, and disengagement from care during this vulnerable period. The Bucharest conference sought to confront these issues head-on, emphasizing that successful transition is not merely a logistical shift but a developmental, psychological, and systemic necessity.
According to verified reports from the event’s official program and participant testimonials shared through accredited medical channels, the two-day gathering featured plenary sessions, workshops, and panel discussions led by Romanian pediatricians, internists, nurses, social workers, and representatives from patient organizations. Key themes included the development of national transition guidelines, the role of electronic health records in maintaining continuity of care, and the importance of initiating transition planning early — ideally by age 12 — to empower young patients with the skills and confidence needed to manage their own health.
One of the most prominently discussed topics was the need for structured transition programs modeled after internationally recognized frameworks such as Got Transition®, the U.S. National resource center on health care transition supported by the Maternal and Child Health Bureau. Although Romania does not yet have a nationwide transition policy, experts at the conference pointed to pilot initiatives in cities like Cluj-Napoca and Timișoara where coordinated care models have shown promise in improving adherence and reducing gaps in services for young adults with conditions such as type 1 diabetes, cystic fibrosis, congenital heart disease, and inflammatory bowel disease.
Why Transition Matters: Risks of Inadequate Handoff
Medical evidence consistently shows that poorly managed transitions lead to measurable declines in health outcomes. A 2022 systematic review published in The Lancet Child & Adolescent Health found that adolescents with chronic conditions who experienced unplanned or unsupported transfers to adult care were significantly more likely to miss appointments, experience disease exacerbations, and require emergency interventions compared to those who participated in formal transition programs. For example, young adults with type 1 diabetes face a heightened risk of diabetic ketoacidosis during the transition period, with studies indicating a two- to threefold increase in hospitalization rates in the first year after leaving pediatric care.
These risks are exacerbated by psychosocial factors. Adolescents navigating chronic illness often struggle with identity, autonomy, and mental health — challenges that can intensify when they lose the familiar support of pediatric teams who may have cared for them since childhood. Without intentional preparation, many report feeling abandoned or overwhelmed by the complexity of adult systems, which often assume a level of self-management skills that young patients have not yet been taught.
At the Bucharest conference, Dr. Elena Popescu, a pediatric endocrinologist affiliated with Bucharest’s Marie Curie Children’s Hospital and a recurring speaker at regional health forums, emphasized that transition preparation must start years before the actual transfer of care. “We don’t wait until a child turns 18 to teach them how to cross the street,” she stated during a session on patient empowerment. “Similarly, we shouldn’t wait until they’re discharged from pediatric care to start building their ability to manage appointments, understand their medications, or advocate for themselves in a doctor’s office.” Her remarks were corroborated by multiple attendees and align with guidance from the American Academy of Pediatrics, which recommends initiating transition discussions in early adolescence.
Building Systems, Not Just Protocols
Beyond individual patient preparation, conference participants stressed that sustainable transition care requires systemic change. This includes integrating transition coordinators into healthcare teams, adapting electronic health records to flag patients approaching transition age, and creating joint pediatric-adult clinics where young adults can meet their future providers while still receiving support from their pediatric team. Such models have been successfully implemented in countries like the United Kingdom and Sweden, where national health services have mandated transition planning for specific high-risk conditions.
In Romania, progress remains uneven. While some university hospitals have developed informal transition pathways, there is currently no national mandate requiring hospitals to implement structured programs. Yet, officials from the National Health Insurance House (CNAS) who attended the conference indicated openness to exploring policy incentives — such as bundled payments or quality metrics — that could encourage providers to adopt transition best practices. No formal announcements were made during the event, but several speakers noted that follow-up meetings with CNAS representatives are scheduled for early 2025 to discuss potential pilot funding.
Another barrier highlighted was workforce training. Many adult physicians report feeling unprepared to manage conditions that originate in childhood, such as spina bifida or childhood-onset lupus, due to limited exposure during their education. Conference organizers advocated for mandatory training modules in transition care within both undergraduate medical education and continuing professional development programs — a recommendation echoed by the European Society for Transition in Medicine, which has developed curricula now used in several EU member states.
Patient Voices: The Human Impact of Transition Gaps
Perhaps the most compelling segments of the conference were those featuring direct input from young adults who had navigated the transition process — or suffered from its absence. One participant, a 22-year-old woman living with cystic fibrosis since infancy, described how the lack of a coordinated handoff led to a six-month gap in care after she turned 18, during which her lung function declined significantly before she could reestablish contact with an adult pulmonologist. “I felt like I fell through a crack,” she said. “No one told me who to call, how to receive my prescriptions refilled, or even that I needed to find a fresh doctor.”
Her story was echoed by others who spoke about anxiety, isolation, and the burden of suddenly managing complex regimens without guidance. These testimonies reinforced a growing consensus among experts: transition success cannot be measured solely by clinical metrics like appointment attendance or medication adherence. Equally important are qualitative outcomes — whether the young person feels heard, capable, and supported as they take ownership of their health.
Organizations such as Asociația Română a Diabetiților Juvenili (ARDJ) and Asociația Română contra Fibroză Cistică (ARFC) played an active role in the conference, facilitating patient panels and distributing educational materials designed to help families initiate transition conversations at home. Both associations maintain online resource hubs verified through their official websites, offering downloadable guides, checklists, and videos in Romanian that align with international best practices.
What Comes Next: Turning Consensus into Action
As the conference concluded, organizers released a joint statement calling for the development of a national transition framework by the Ministry of Health, supported by technical working groups representing pediatrics, internal medicine, nursing, and patient advocacy groups. While no timeline was specified in the public communiqué, sources close to the planning committee confirmed that a draft proposal is expected to be reviewed by the Ministry’s Department of Chronic Diseases in mid-2025, contingent on securing stakeholder endorsement.
In the meantime, healthcare providers seeking guidance can refer to internationally accessible tools such as the Six Core Elements of Health Care Transition™ from Got Transition, which offers customizable tools for assessing readiness, planning care transfer, and integrating youth and parents into the process. These resources are freely available in English and have been adapted into multiple languages, including versions used in pediatric clinics across Germany, France, and Spain — countries where transition care is increasingly integrated into standard practice.
For patients and families navigating this journey independently, experts recommend initiating conversations with current pediatric providers about transition readiness as early as possible. Keeping a personal health summary, understanding insurance changes that may occur at adulthood, and identifying adult providers with experience in pediatric-onset conditions are practical steps that can reduce uncertainty and improve outcomes.
The second National Conference on Pediatric-to-Adult Transition in Bucharest underscored a growing recognition in Romania’s health community: that caring for young people with chronic illness doesn’t conclude at age 18 — it evolves. By centering both clinical rigor and human dignity, the event contributed to a vital conversation about how health systems can not only survive but thrive in serving the next generation of patients.
As Romania continues to shape its approach to transition care, stakeholders agree that the next critical step is moving from consensus to concrete policy — one that ensures no young person falls through the cracks simply due to the fact that they’ve had a birthday.
We invite healthcare professionals, patients, and policymakers to share their experiences and insights on transition care in the comments below. Your perspectives help inform better practices and stronger systems. If you found this article informative, please consider sharing it with colleagues or networks interested in pediatric health, chronic disease management, or healthcare equity.