Medical home and pediatric primary care utilization among children with special health care needs

J Pediatr Health Care. 2013 May-Jun;27(3):202-8. doi: 10.1016/j.pedhc.2011.11.004. Epub 2012 Jan 13.

Abstract

Introduction: The medical home model seeks to improve health care delivery by enhancing primary care. This study examined the relationship between the presence of a medical home and pediatric primary care office visits by children with special health care needs (CSHCN) using the data from 2005-2006 National Survey of Children with Special Healthcare Needs.

Method: Survey logistic regression was used to analyze the relationship.

Results: When CSHCN age, gender, ethnicity/race, functional status, insurance status, household education, residence, and income were included in the model, CSHCN with a medical home were 1.6 times more likely to have six or more annual pediatric primary care office visits than were children without a medical home [odds ratio = 1.60, 95% confidence interval = (1.47, 1.75)]. Female CSHCN, younger CSHCN, children with public health insurance, children with severe functional limitations, and CSHCN living in rural areas also were more likely to have a larger number of visits.

Discussion: By controlling for child sociodemographic characteristics, this study provides empirical evidence about how medical home availability affects primary care utilization by CSHCN.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Health Services Needs and Demand*
  • Humans
  • Infant
  • Infant, Newborn
  • Multivariate Analysis
  • Pediatrics*
  • Primary Health Care / statistics & numerical data*