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The Pediatric Inflammatory Bowel Disease Medical Home: A Proposed Model
Hilary K Michel1,2, Brendan Boyle1,2, Jennie David3
1Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA.
Insights
The patient-centered medical home (PCMH) model improves adult inflammatory bowel disease (IBD) care. Applying PCMH principles to pediatric IBD care is crucial for addressing unique developmental and transitional needs.
Area of Science:
- Gastroenterology
- Pediatric Care
- Healthcare Management
Background:
- Inflammatory bowel disease (IBD) care presents significant complexity and cost challenges.
- The patient-centered medical home (PCMH) model has shown success in adult IBD management.
- Pediatric IBD patients have unique needs including growth, development, and care transition.
Purpose of the Study:
- To review the application of the PCMH model in adult IBD care.
- To describe a pediatric IBD medical home model.
- To propose a research agenda for comprehensive pediatric IBD care delivery.
Main Methods:
- Literature review of PCMH in adult IBD.
- Description of a pediatric IBD medical home care delivery model.
- Proposal of future research directions.
Main Results:
- The PCMH model, adapted as a specialty medical home (SMH), improves outcomes through team-based, coordinated, and patient-centered care.
- Pediatric IBD requires specialized attention to developmental and transitional care needs beyond adult IBD management.
- A pediatric IBD medical home model can address these unique challenges.
Conclusions:
- The PCMH framework is highly relevant and potentially more critical for pediatric and adolescent IBD care.
- Implementing a pediatric IBD medical home is essential for optimizing care quality and outcomes.
- Further research is needed to develop and disseminate comprehensive pediatric IBD care models.
Abstract:
Care for patients with inflammatory bowel disease (IBD) can be complex and costly. Care delivery models to address these challenges and improve care quality are essential. The patient-centered medical home (PCMH), which was developed in the primary care setting, has recently been applied successfully to the adult IBD population. Following the tenets of the PCMH, this specialty medical home (SMH) emphasizes team-based care that is accessible, comprehensive, patient/family-centered, coordinated, compassionate, and continuous and has demonstrated improved patient outcomes. Children and young adults with IBD have equally complex care needs, with additional challenges not faced by the adult population such as growth, physical and psychosocial development, and transition of care from pediatric to adult providers. Thus, we advocate that the components of the PCMH are equally-if not more-important in caring for the pediatric patient population. In this article, we review what is known about the application of the PCMH model in adult IBD care, describe care delivery within the Center for Pediatric and Adolescent IBD at Nationwide Children's Hospital as an example of a pediatric IBD medical home, and propose a research agenda to further the development and dissemination of comprehensive care delivery for children and adolescents with IBD.
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