Children without a true medical home--defined as a usual source of care, a personal physician or nurse, receipt of all needed referrals for specialty care, effective care coordination and receipt of family-centered care--may be three to four times more likely to have an unmet medical or dental need, according a new study published in Pediatrics. Children who received care in medical homes also were more likely to have annual preventive medical visits, the study found.
However, researchers' analysis of 83,448 children under 18, using data from the 2007 National Survey of Children's Health, found that only 56.9 percent had all five components of a medical home. According to study lead author Bonnie Strickland, PhD, the children with the greatest need--such as those with chronic health conditions or special needs--were the least likely to have access to this type of care. The team also discovered disparities among children older than six, minorities and those whose families earned less than four times the federal poverty level.
While Strickland, director of the U.S. Health Resources and Services Administration's division of services for children with special healthcare needs, acknowledged that coverage for individual components of the medical home was much higher, she urged continued efforts for practices to pursue the model to its fullest.
"A lot of people think of the medical home as a source of primary care, or just a place to go when you need to see a doctor, but it's far, far more than that," Strickland said. "That's why there is a high expectation that medical homes may be a very important factor in improving care in this country."