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Medical home quality and readmission risk for children hospitalized with asthma exacerbations

Katherine A Auger1, Robert S Kahn, Matthew M Davis

  • 1Robert Wood Johnson Foundation Clinical Scholars Program, and Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan 48109-2800, USA. kasauger@gmail.com

Pediatrics
|December 12, 2012
PubMed

Insights

Poor access to a medical home increases readmission risk for children hospitalized with asthma. Improving physician access may reduce asthma hospital readmissions, enhancing pediatric care.

Area of Science:

  • Pediatric Healthcare
  • Health Services Research
  • Asthma Management

Background:

  • The medical home model is linked to improved outpatient outcomes for pediatric asthma.
  • Limited data exists on the impact of medical home quality on healthcare utilization post-hospitalization for asthma.

Purpose of the Study:

  • To investigate the association between medical home quality and readmission risk in children hospitalized for asthma exacerbations.
  • To explore specific aspects of medical home quality that influence readmission rates.

Main Methods:

  • A cohort of 601 children (1-16 years) hospitalized for asthma exacerbation was studied.
  • Caregivers completed the Parent's Perception of Primary Care (P3C) survey to assess medical home quality.
  • Asthma readmissions were tracked prospectively, with readmission risk analyzed using Cox proportional hazards models.

Main Results:

  • The overall medical home quality score (P3C) did not correlate with readmission rates.
  • Only children with the poorest access to their medical home showed a statistically significant increase in readmission risk.
  • Children with private insurance and good medical home access had the lowest 1-year readmission rates.

Conclusions:

  • Poor access to a medical home was the sole identified quality measure associated with increased readmission risk in hospitalized pediatric asthma patients.
  • Enhancing physician access for children with asthma could potentially decrease hospital readmission rates.
Abstract

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