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Enhanced Access and Parents' Preferred Contact for a Child's Chronic Condition
Neal A deJong1, Elisabeth P Dellon2, Emily B Vander Schaaf1
1Division of General Pediatrics and Adolescent Medicine, UNC School of Medicine, Chapel Hill, NC.
Insights
Parents prefer contacting specialty practices for their child's chronic condition flare-ups when they perceive enhanced access, particularly through electronic communication and care coordination. Primary care access did not influence this preference.
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.
Objectives:
To assess whether the perception of enhanced access by parents in their child's primary care and main specialty practices is associated with preference for contacting either practice when problems arise with a child's chronic condition.
Study Design:
In this cross-sectional survey study of parents whose children use both primary and specialty practices, we assessed perceptions of 3 components of enhanced access: (1) appointment availability when needed, (2) electronic communication with practices, and (3) other staff that help manage a child's health care needs. Parents also indicated which practice they would contact for an exacerbation of the main chronic condition for which the child receives specialty care. We used logistic regression to examine relationships of enhanced access components in both practices with parents' indicated practice.
Results:
Among 609 parents, 244 (40%) would contact primary care and 365 (60%) the main specialty practice for a chronic condition exacerbation. Although parents perceived enhanced access components with similar frequency in both settings, enhanced access was associated only with preference for contacting the main specialty practice: e-mail communication (aOR for preferring the specialty practice 2.0 [1.3, 3.2]) and staff that coordinate a child's care needs (aOR 2.8 [1.4, 5.9]).
Conclusions:
Enhanced access is associated with preference for addressing chronic condition exacerbations in specialty but not primary care. Future study should further identify factors important to parents in deciding when and how to contact practices and should seek to develop family-centered communication within medical homes that integrate primary and specialty care.
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