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Outcomes for Children with Chronic Conditions Associated with Parent- and Provider-reported Measures of the Medical
Insights
Having a usual source of care and strong practice organization reduced emergency visits and hospitalizations for low-income children with chronic conditions. This highlights the importance of patient-centered medical homes (PCMH) in managing care for vulnerable populations.
Area of Science:
- Pediatric Health Services Research
- Health Care Management
- Chronic Disease Management
Background:
- Low-income children with chronic conditions often face challenges in accessing consistent health care.
- The patient-centered medical home (PCMH) model aims to improve care coordination and patient experience.
- Understanding factors influencing healthcare utilization is crucial for optimizing care for this population.
Purpose of the Study:
- To examine the association between patient-centered medical home (PCMH) characteristics and healthcare utilization.
- To compare parent and practice perspectives on PCMH and its impact on service use.
- To investigate healthcare utilization patterns in low-income children with chronic conditions.
Main Methods:
- Analysis of data from 240 publicly insured children with chronic conditions.
- Parental surveys assessed PCMH access.
- Practice self-assessments using the Medical Home Index (MHI) were conducted.
- Multivariate negative binomial regression analyses were used to explore relationships between PCMH and service use.
Main Results:
- Parent-reported usual source of care correlated with reduced emergency department (ED) visits and hospitalizations.
- Higher practice organizational capacity (communication, staff education) was linked to fewer ED visits and hospitalizations.
- Parental reports of PCMH were positively associated with higher practice MHI scores.
Conclusions:
- A usual source of care and robust practice organizational capacity are associated with decreased healthcare utilization in low-income children with chronic conditions.
- These findings underscore the value of PCMH in mitigating healthcare use for vulnerable pediatric populations.
- Improving practice capacity and ensuring a usual source of care can lead to better health outcomes and reduced healthcare costs.
Purpose:
Assess relationships between having a patient-centered medical home (PCMH) and health care utilization among low-income children with chronic conditions using parent and practice perspectives.
Methods:
We analyzed data from 240 publicly insured children with chronic conditions. Parents completed surveys assessing PCMH access and their child's primary care practice completed the Medical Home Index (MHI) self-assessment. Multivariate negative binomial analyses were conducted to investigate relationships between PCMH and service use.
Results:
Parent-report of a usual source of care was associated with lower rates of emergency care (ED) encounters and hospitalizations. Practice report of higher organizational capacity (e.g., communication, staff education) was associated with lower rates of ED visits and hospitalizations. Parent report of a PCMH was positively associated with practice MHI score.
Conclusions:
Among low-income children with chronic conditions, having a usual source of care and higher quality organizational capacity were associated with lower rates of ED visits and hospitalizations.
