Comparing medical homes for children with ADHD and asthma

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Sara L Toomey1, Charles J Homer, Jonathan A Finkelstein

  • 1Children's Hospital Boston, Harvard Medical School, Mass. 02215, USA. sara.toomey@childrens.harvard.edu

Academic Pediatrics
|February 5, 2010
PubMed

Insights

Parents of children with attention-deficit/hyperactivity disorder (ADHD) report poorer access to a medical home compared to children with asthma. Key dimensions like family-centered and coordinated care are lacking for children with ADHD.

Area of Science:

  • Pediatric Health Services Research
  • Childhood Neurodevelopmental Disorders
  • Chronic Pediatric Illness Management

Background:

  • Access to a medical home is crucial for children with special healthcare needs.
  • Attention-deficit/hyperactivity disorder (ADHD) and asthma are common childhood conditions requiring ongoing care.
  • Understanding disparities in medical home access is vital for improving pediatric primary care.

Purpose of the Study:

  • To compare the characteristics associated with having a medical home for children with ADHD versus asthma.
  • To determine if children with ADHD are less likely to have a medical home than children with asthma, controlling for key characteristics.
  • To identify specific components of a medical home that are deficient for children with ADHD compared to those with asthma.

Main Methods:

  • Cross-sectional analysis using the 2005-2006 National Survey of Children with Special Health Care Needs (NS-CSHCN).
  • Parental report of their child's practice having specific medical home attributes was the outcome variable.
  • Multivariate logistic regression was employed to compare medical home likelihood and component differences between ADHD and asthma cohorts.

Main Results:

  • Analysis included 11,674 children with ADHD and 13,517 children with asthma (ages 4-17).
  • Children with ADHD were significantly less likely to have a medical home compared to children with asthma (OR 0.68; P < .001).
  • Deficiencies were noted in family-centered care (OR 0.79; P < .001) and coordinated care (OR 0.59; P < .001) for children with ADHD.

Conclusions:

  • Parents of children with ADHD report inferior primary care performance across critical dimensions compared to parents of children with asthma.
  • Significant improvements in family-centered and coordinated care are necessary for primary care to effectively meet the needs of children with ADHD.
  • Addressing these gaps can enhance the overall quality of care for pediatric ADHD patients.
Abstract

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