The Medical Home, Access to Care, and Insurance: A Review of Evidence

Author:

Starfield Barbara1,Shi Leiyu1

Affiliation:

1. From the Department of Health Policy and Management, Johns Hopkins University School of Public Health, Baltimore, Maryland

Abstract

Objective. To review the extent to which the literature supports the position that a medical home is important and to review the extent to which insurance is related to having a medical home. Methods. A review of literature concerning the benefits of a medical home on effectiveness, costs, and equity (reducing disparities) was conducted. Results. International and within-nation studies indicate that a relationship with a medical home is associated with better health, on both the individual and population levels, with lower overall costs of care and with reductions in disparities in health between socially disadvantaged subpopulations and more socially advantaged populations. Although important in facilitating use overall, insurance does not guarantee a medical home. Conclusions. A medical home, with its 4 key features, provides better effectiveness as well as more efficient and more equitable care to individuals and populations. A concerted attempt to provide a means of universal financial access as well as a medical home should be of high priority for the United States.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

Reference49 articles.

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2. American Academy of Pediatrics Medical Home Initiatives for Children With Special Needs Project Advisory Committee. The medical home. Pediatrics.2002;110:184–186

3. Citizens Commission on Graduate Medical Education. The Graduate Education of Physicians. Report of the Citizens Commission on Graduate Medical Education. Chicago, IL: American Medical Association; 1966

4. Alpert JJ, Charney E. The Education of Physicians for Primary Care. Rockville, MD: US Department of Health, Education, and Welfare, Bureau of Health Service, Resources; 1973 (Publication no. [HRA] 74-3113)

5. Donaldson MS, Yordy KD, Lohr KN, Vanselow NA. Primary Care: America's Health in a New Era. Washington, DC: National Academy Press; 1996

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