Factors associated with a medical home among children with Attention-Deficit Hyperactivity Disorder

Caprice A Knapp1, Melanie Hinojosa, Jacqueline Baron-Lee

  • 1Department of Health Outcomes and Policy, University of Florida, 1329 SW 16th Street, Room 5130, Gainesville, FL 32610, USA. cak@ichp.ufl.edu

Insights

Children with Attention-Deficit Hyperactivity Disorder (ADHD) and comorbidities are less likely to have a medical home. Having a medical home improves some health outcomes but may hinder mental health care access for these children.

Area of Science:

  • Pediatric Health
  • Healthcare Access
  • Child Psychology

Background:

  • Providing a medical home for children with Attention-Deficit Hyperactivity Disorder (ADHD) presents unique challenges.
  • Limited understanding exists regarding factors influencing medical home access for children with ADHD and the impact of comorbidities.
  • Comorbidities in children with ADHD can complicate care and affect their access to a consistent medical home.

Purpose of the Study:

  • To identify factors associated with having a medical home and its five sub-components for children with ADHD.
  • To determine the effect of having a medical home on various health outcomes for children with ADHD.
  • To analyze how comorbidities influence the likelihood of children with ADHD having a medical home.

Main Methods:

  • Utilized data from 5,495 children with ADHD from the 2007 National Survey of Children's Health.
  • Conducted descriptive and multivariate analyses to examine associations and effects.
  • Compared children with ADHD alone, ADHD with physical diagnoses, and ADHD with mental diagnoses regarding medical home access.

Main Results:

  • Children with ADHD and physical diagnoses had higher frequencies of medical home access compared to those with ADHD and mental diagnoses.
  • Children with ADHD and physical and/or mental comorbidities were 24-63% more likely to lack a medical home than those with ADHD alone.
  • Medical home access was linked to fewer unmet health needs and missed school days, but also to less access to needed mental health care.

Conclusions:

  • Parental perceptions of care differ for children with ADHD, particularly concerning medical home access.
  • Pediatric medical home initiatives and policies must address the complexities of ADHD care, especially when comorbidities are present.
  • Practice transformation and reimbursement policies should be adapted to better support children with ADHD and their complex care needs.

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