Enhanced Access and Parents' Preferred Contact for a Child's Chronic Condition

Area of Science:

• Pediatric Healthcare Access
• Patient Engagement Strategies
• Healthcare Management

Background:

• Understanding parental preferences for contacting healthcare providers is crucial for managing children's chronic conditions.
• Enhanced access, encompassing appointment availability, electronic communication, and care coordination, may influence these preferences.
• The role of primary care versus specialty care in managing chronic condition exacerbations needs further investigation.

Purpose of the Study:

• To determine if parents' perception of enhanced access in primary care and specialty practices correlates with their choice of contact during a child's chronic condition exacerbation.
• To identify specific components of enhanced access that influence parental preference for contacting either primary or specialty care.

Main Methods:

• A cross-sectional survey was conducted with parents of children utilizing both primary and specialty care.
• Perceptions of enhanced access (appointment availability, electronic communication, care coordination) were assessed for both practice types.
• Logistic regression analysis examined the association between enhanced access components and the preferred practice for contacting during a chronic condition exacerbation.

Main Results:

• Of 609 parents surveyed, 60% indicated they would contact the specialty practice, while 40% would contact the primary care practice for a chronic condition exacerbation.
• While parents reported similar levels of enhanced access in both settings, only the specialty practice showed a significant association with preference.
• Specific enhanced access components, including e-mail communication (aOR 2.0) and care-coordinating staff (aOR 2.8), were significantly associated with preferring the specialty practice.

Conclusions:

• Enhanced access, particularly electronic communication and care coordination, is linked to parents' preference for contacting specialty practices for chronic condition exacerbations.
• Enhanced access in primary care settings did not significantly influence the preference for contacting primary care for these specific issues.
• Future research should focus on identifying parental decision-making factors and developing integrated, family-centered communication strategies within medical homes.