Affiliation:
1. Maternal and Child Health Bureau Health, Resources and Services Administration, Washington, DC
2. Children’s National Medical Center, George Washington University Medical Center, Washington, DC
3. Institute for Health Policy Studies and Department of Pediatrics, University of California at San Francisco, San Francisco, California
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.
Publisher
American Academy of Pediatrics (AAP)
Subject
Pediatrics, Perinatology and Child Health
Reference24 articles.
1. US Department of Health and Human Services. Assuring Access to Essential Health Care. Washington, DC: Health Resources and Services Administration; 1999
2. Newacheck PW, Pearl M, Hughes DC, Halfon N. The role of Medicaid in ensuring children’s access to care. JAMA.1998;280:1789–1793
3. Bethell C, Peck C, Abrams M, Halfon N, Sareen H, Collins KS. Partnering With Parents to Promote the Healthy Development of Young Children Enrolled in Medicaid: Results From a Survey Assessing the Quality of Preventive and Developmental Services for Young Children Enrolled in Medicaid in Three States. New York, NY: The Commonwealth Fund; 2002 Available at: www.cmwf.org/programs/child/bethell%5Fpartnering%. Accessed May 21, 2003
4. American Academy of Pediatrics Medical Home Initiatives for Children With Special Needs Project Advisory Committee. Policy statement: the medical home. Pediatrics.2002;110:184–186
5. National Maternal and Child Health Resource Center. A National Goal: Building Service Delivery Systems for Children With Special Health Care Needs and Their Families—Family Centered Community Based Coordinated Care. Iowa City, IA: National Maternal and Child Health Resource Center; 1987
Cited by
72 articles.
订阅此论文施引文献
订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献