Presence and Characteristics of Medical Home and Health Services Utilization Among Children With Asthma
Abstract
Introduction
Having a medical home is advocated by the National Association of Pediatric Nurse Practitioners and others, yet there is limited research that documents desired health benefits. We examine the presence of medical home characteristics and describe relationships between medical home and health services utilization in a national sample that includes children with asthma.
Method
Medical home is represented by: (a) the presence of a usual source of care (USC), (b) identification of a named person as USC, and (c) a 10-item index of other medical home characteristics. Health services utilization over a calendar year is measured by (a) emergency department visits for asthma, (b) wellness examination, and (c) rescue bronchodilator fill/refill. Analyses include chi-square and logistic regression.
Results
A USC was reported for 95% of participants. Children with a USC were more likely to have a wellness examination (odds ratio, 2.10; 95% confidence interval, 1.15-3.81). Overall, 51% reported the USC to be a facility versus a named person. Identifying a person as the USC was related to higher scores on the 10-item medical home index but not to other outcomes.
Discussion
Most parents were satisfied with the USC. Benefits of having a USC, but not necessarily a named person, appear in preventive actions.
Reprint requests: Gail M. Kieckhefer, PhD, ARNP, Department of Family & Child Nursing, Box 357262, University of Washington, Seattle, WA 98195-7262
This research was supported by grant No. RO1-HS 13110 from the Agency for Healthcare Research and Quality. Dr. Kieckhefer’s work also was supported in part by Project T 72 MC 00007 from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services.
ABSTRACT