Contributions of Key Components of a Medical Home on Child Health Outcomes

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: The medical home model is a widely accepted model of team-based primary care. We examined five components of the medical home model in order to better understand their unique contributions to child health outcomes. Methods: We analyzed data from the 2016–2017 National Survey of Children’s Health (NSCH) to assess five key medical home components – usual source of care, personal doctor/nurse, family-centered care, referral access, and coordinated care – and their associations with child outcomes. Health outcomes included emergency department (ED) visits, unmet health care needs, preventive medical visits, preventive dental visits, health status, and oral health status. We used multivariate regression controlling for child characteristics including age, sex, primary household language, race/ethnicity, income, parental education, health insurance coverage, and special healthcare needs. Results: Children who were not white, living in non-English households, with less family income or education, or who were uninsured had lower rates of access to a medical home and its components. A medical home was associated with beneficial child outcomes for all six of the outcomes and the family-centered care component was associated with better results in five outcomes. ED visits were less likely for children who received care coordination (aOR 0.81, CI 0.70–0.94). Conclusions for Practice: Our study highlights the role of key components of the medical home and the importance of access to family-centered health care that provides needed coordination for children. Health care reforms should consider disparities in access to a medical home and specific components and the contributions of each component to provide quality primary care for all children.

Original languageEnglish (US)
Pages (from-to)476-486
Number of pages11
JournalMaternal and child health journal
Volume27
Issue number3
DOIs
StatePublished - Mar 2023

Bibliographical note

Funding Information:
We studied the health outcomes of children with a medical home or specific medical home components compared to those without a medical home or specific components. Study data were from the 2016–2017 National Survey of Children’s Health (NSCH), a nationally representative cross-sectional survey of noninstitutionalized children aged 0–17. The NSCH is directed by the Health Resources and Services Administration’s Maternal and Child Health Bureau (MCHB). Since 2016, the redesigned NSCH has been conducted as a mail and web-based survey by the Census Bureau, which is subject to appropriate ethical standards including informed consent. This survey provides comprehensive data on children’s physical health, mental health, and access to primary care, and characteristics of children and their families, including whether the child has special health care needs. A series of items in this survey captures family experiences related to medical home access, based on the AAP definition.(CAHMI, n.d.-a). We used publicly available, de-identified data via the Child and Adolescent Health Measurement Initiative (CAHMI), which is supported by MCHB.

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

  • Children’s health
  • Family-centered
  • Medical home
  • Medical home components
  • National Survey of Children’s Health

PubMed: MeSH publication types

  • Journal Article

Fingerprint

Dive into the research topics of 'Contributions of Key Components of a Medical Home on Child Health Outcomes'. Together they form a unique fingerprint.

Cite this