Nonemergency Acute Care: When It's Not the Medical Home

Area of Science:

• Pediatric Health Services
• Healthcare Delivery Models
• Acute Care Management

Background:

• The American Academy of Pediatrics (AAP) defines the medical home as the optimal setting for children's acute, non-emergency healthcare.
• Families may seek care outside the medical home due to perceived benefits in accessibility, convenience, or cost.
• Alternative acute care settings include urgent care facilities, retail clinics, and telemedicine services.

Purpose of the Study:

• To affirm the importance of the medical home for pediatric acute care.
• To outline core principles for acute care entities outside the medical home.
• To advocate for policies supporting the medical home model.

Main Methods:

• Policy statement review and synthesis.
• Analysis of current pediatric acute care delivery trends.
• Recommendations for stakeholders and payers.

Main Results:

• The medical home model emphasizes accessibility, family-centeredness, continuity, comprehensiveness, coordination, compassion, and cultural effectiveness.
• Children require high-quality, safe acute care regardless of the access point.
• Timely and complete communication between external acute care providers and the medical home is crucial for coordinated care.

Conclusions:

• Acute care entities must adhere to principles of continuity, communication, best practices, pediatric-trained staff, safe transitions, and continuous improvement.
• The AAP urges payers to avoid incentives that promote external acute care over the medical home.
• Ensuring coordinated and continuous care is paramount for pediatric health outcomes.