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Access to the medical home: results of the National Survey of Children with Special Health Care Needs.
Pediatrics. 2004 May; 113(5 Suppl):1485-92.Ped

Abstract

OBJECTIVE

The purpose of this article is to report the findings of the National Survey of Children With Special Health Care Needs regarding parent perceptions of the extent to which children with special health care needs (CSHCN) have access to a medical home.

METHODS

Five criteria, selected to reflect the characteristics of a medical home as defined by the American Academy of Pediatrics (AAP) policy statement on the medical home, were analyzed to describe the extent to which CSHCN receive care characteristic of the medical home concept. These criteria included having 1) a usual place for sick/well care, 2) a personal doctor or nurse, 3) no difficulty in obtaining needed referrals, 4) needed care coordination, and 5) family-centered care received. Items from the Survey were selected and clustered to characterize each of the 5 components. Criteria for each item were established with the requirement that the criteria must be met for all items in a component to receive credit for the component.

RESULTS

Results of the survey indicate that 1) approximately half of CSHCN receive care that meets all 5 components established for medical home; 2) most CSHCN have a usual source of care and a personal doctor or nurse, but other components of the medical home, especially elements of care coordination and family-centered care, are lacking; 3) access to a medical home is significantly affected by race/ethnicity, poverty, and the limitations imposed on daily activity by the child's special health care need; and 4) parents of children who do have a medical home report significantly less delayed or forgone care, significantly fewer unmet health care needs, and significantly fewer unmet needs for family support services. The 5 components described represent major characteristics of the comprehensive care model recommended for all children by the AAP.

CONCLUSIONS

The findings suggest that although some components of the medical home concept have been achieved for most CSHCN, the comprehensive care model described by the AAP policy statement on the medical home is not yet in place for a significant number of CSHCN and their families.

Authors+Show Affiliations

Maternal and Child Health Bureau Health, Resources and Services Administration, Washington, DC, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15121916

Citation

Strickland, Bonnie, et al. "Access to the Medical Home: Results of the National Survey of Children With Special Health Care Needs." Pediatrics, vol. 113, no. 5 Suppl, 2004, pp. 1485-92.
Strickland B, McPherson M, Weissman G, et al. Access to the medical home: results of the National Survey of Children with Special Health Care Needs. Pediatrics. 2004;113(5 Suppl):1485-92.
Strickland, B., McPherson, M., Weissman, G., van Dyck, P., Huang, Z. J., & Newacheck, P. (2004). Access to the medical home: results of the National Survey of Children with Special Health Care Needs. Pediatrics, 113(5 Suppl), 1485-92.
Strickland B, et al. Access to the Medical Home: Results of the National Survey of Children With Special Health Care Needs. Pediatrics. 2004;113(5 Suppl):1485-92. PubMed PMID: 15121916.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Access to the medical home: results of the National Survey of Children with Special Health Care Needs. AU - Strickland,Bonnie, AU - McPherson,Merle, AU - Weissman,Gloria, AU - van Dyck,Peter, AU - Huang,Zhihuan J, AU - Newacheck,Paul, PY - 2004/5/4/pubmed PY - 2004/5/14/medline PY - 2004/5/4/entrez SP - 1485 EP - 92 JF - Pediatrics JO - Pediatrics VL - 113 IS - 5 Suppl N2 - OBJECTIVE: The purpose of this article is to report the findings of the National Survey of Children With Special Health Care Needs regarding parent perceptions of the extent to which children with special health care needs (CSHCN) have access to a medical home. METHODS: Five criteria, selected to reflect the characteristics of a medical home as defined by the American Academy of Pediatrics (AAP) policy statement on the medical home, were analyzed to describe the extent to which CSHCN receive care characteristic of the medical home concept. These criteria included having 1) a usual place for sick/well care, 2) a personal doctor or nurse, 3) no difficulty in obtaining needed referrals, 4) needed care coordination, and 5) family-centered care received. Items from the Survey were selected and clustered to characterize each of the 5 components. Criteria for each item were established with the requirement that the criteria must be met for all items in a component to receive credit for the component. RESULTS: Results of the survey indicate that 1) approximately half of CSHCN receive care that meets all 5 components established for medical home; 2) most CSHCN have a usual source of care and a personal doctor or nurse, but other components of the medical home, especially elements of care coordination and family-centered care, are lacking; 3) access to a medical home is significantly affected by race/ethnicity, poverty, and the limitations imposed on daily activity by the child's special health care need; and 4) parents of children who do have a medical home report significantly less delayed or forgone care, significantly fewer unmet health care needs, and significantly fewer unmet needs for family support services. The 5 components described represent major characteristics of the comprehensive care model recommended for all children by the AAP. CONCLUSIONS: The findings suggest that although some components of the medical home concept have been achieved for most CSHCN, the comprehensive care model described by the AAP policy statement on the medical home is not yet in place for a significant number of CSHCN and their families. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/15121916/Access_to_the_medical_home:_results_of_the_National_Survey_of_Children_with_Special_Health_Care_Needs_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=15121916 DB - PRIME DP - Unbound Medicine ER -