Unmet Health Care Needs of Adult Patients Adopted in Childhood: Insights and Recommendations.

Abstract

There is limited literature and guidance on the care of adopted patients in the medical setting beyond childhood. We examined the health care challenges faced by adults who were adopted as children and the perceived impact on the patient-clinician relationship. We administered a mixed-methods online survey to US adult adoptees examining perception of how adoptee status impacts their health care interactions. Quantitative data were analyzed descriptively and with a multivariate logistic regression model to assess associations between adoption-related health care experiences and care-seeking behaviors. Qualitative data were analyzed and organized thematically into 5 major themes. Analyses were based on 204 adults adopted in childhood. The majority reported that their medical professionals had gaps in their knowledge about adoption, especially regarding how limited family medical history can contribute to negative health outcomes. Most participants perceived multiple distinct types of adoption-related discrimination by clinicians. Those who experienced these negative interactions sometimes or more often had greater than 7 times the adjusted odds of delaying care or changing clinicians when compared with adoptees who experienced this discrimination rarely or not at all. In this exploratory study, we found that adoptees perceive medical professionals' lack of knowledge of the health implications of adoption as detrimental to their care and as undermining the patient-clinician relationship. Our findings suggest that adoption is both an experience and a potential identity with health implications that clinicians should be prepared to recognize and address.