Document Detail

The value of the medical home for children without special health care needs.
MedLine Citation:
PMID:  22184647     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Although the medical home is promoted by the American Academy of Pediatrics and the Affordable Care Act, its impact on children without special health care needs is unknown. We examined whether the medical home is associated with beneficial health care utilization and health-promoting behaviors in this population.
METHODS: This study was a secondary data analysis of the 2003 National Survey of Children's Health. Data were available for 70 007 children without special health care needs. We operationalized the medical home according to the National Survey of Children's Health design. Logistic regression for complex sample surveys was used to model each outcome with the medical home, controlling for sociodemographic characteristics.
RESULTS: Overall, 58.1% of children without special health care needs had a medical home. The medical home was significantly associated with increased preventive care visits (adjusted odds ratio [aOR]: 1.32 [95% confidence interval (CI): 1.22-1.43]), decreased outpatient sick visits (aOR: 0.71 [95% CI: 0.66-0.76), and decreased emergency department sick visits (aOR: 0.70 [95% CI: 0.65-0.76]). It was associated with increased odds of "excellent/very good" child health according to parental assessment (aOR: 1.29 [95% CI: 1.15-1.45) and health-promoting behaviors such as being read to daily (aOR: 1.46 [95% CI: 1.13-1.89]), reported helmet use (aOR: 1.18 [95% CI: 1.03-1.34]), and decreased screen time (aOR: 1.12 [95% CI: 1.02-1.22]).
CONCLUSIONS: For children without special health care needs, the medical home is associated with improved health care utilization patterns, better parental assessment of child health, and increased adherence with health-promoting behaviors. These findings support the recommendations of the American Academy of Pediatrics and the Affordable Care Act to extend the medical home to all children.
Webb E Long; Howard Bauchner; Robert D Sege; Howard J Cabral; Arvin Garg
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2011-12-19
Journal Detail:
Title:  Pediatrics     Volume:  129     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-02     Completed Date:  2012-02-14     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  87-98     Citation Subset:  AIM; IM    
Department of Pediatrics, Boston University School of Medicine/Boston Medical Center, Boston, MA 02118, USA.
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MeSH Terms
Child Health Services / utilization*
Child Welfare*
Health Promotion*
Patient-Centered Care / utilization*
Preventive Health Services
Socioeconomic Factors
Grant Support
6 T32 HP 10263-01//PHS HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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