Access to the Medical Home Among Children With and Without Special Health Care Needs.

Autor:	Lichstein JC; Health Resources and Services Administration, Maternal and Child Health Bureau, Rockville, Maryland jlichstein@hrsa.gov., Ghandour RM; Health Resources and Services Administration, Maternal and Child Health Bureau, Rockville, Maryland., Mann MY; Health Resources and Services Administration, Maternal and Child Health Bureau, Rockville, Maryland.
Jazyk:	angličtina
Zdroj:	Pediatrics [Pediatrics] 2018 Dec; Vol. 142 (6).
DOI:	10.1542/peds.2018-1795
Abstrakt:	: media-1vid110.1542/5840358562001PEDS-VA_2018-1795 Video Abstract OBJECTIVES: The medical home is central to providing quality health care for children. Access to the medical home has historically been tracked by using the National Survey of Children With Special Health Care Needs and the National Survey of Children's Health (NSCH). Between 2012 and 2015, the NSCH was redesigned, combining the 2 surveys into a single, annual assessment. In this study, we provide the latest estimates of medical home access among children in the United States. Methods: We used data from the 2016 NSCH ( N = 50 212). Medical home access was defined as a composite measure composed of 5 subcomponents (usual source of care, personal doctor or nurse, referral access, receipt of care coordination, and receipt of family-centered care) for 50 177 US children aged 0 to 17 years. We conducted bivariate analyses and logistic regression to examine the sociodemographic and health characteristics associated with reported attainment of the medical home composite measure and each subcomponent. Analyses were survey weighted. Results: In 2016, 43.2% of children with special health care needs (CSHCN) and 50.0% of non-CSHCN were reported to have access to a medical home. Attainment of the medical home composite measure varied significantly by sociodemographic characteristics among both CSHCN and non-CSHCN, as did attainment rates for each of the 5 subcomponents. The medical complexity of CSHCN was also associated with attainment rates of all outcomes. Conclusions: The medical home incorporates elements of care considered necessary for providing comprehensive, quality care. Our results indicate that there is still room to improve access to the medical home among all children. Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose. (Copyright © 2018 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
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