The medical home, access to care, and insurance: a review of evidence.
OBJECTIVE
To review the extent to which the literature supports the position that a medical home is important and to review the extent to which insurance is related to having a medical home.


METHODS
A review of literature concerning the benefits of a medical home on effectiveness, costs, and equity (reducing disparities) was conducted.


RESULTS
International and within-nation studies indicate that a relationship with a medical home is associated with better health, on both the individual and population levels, with lower overall costs of care and with reductions in disparities in health between socially disadvantaged subpopulations and more socially advantaged populations. Although important in facilitating use overall, insurance does not guarantee a medical home.


CONCLUSIONS
A medical home, with its 4 key features, provides better effectiveness as well as more efficient and more equitable care to individuals and populations. A concerted attempt to provide a means of universal financial access as well as a medical home should be of high priority for the United States.
Starfield
Barbara
B
Department of Health Policy and Management, Johns Hopkins University School of Public Health, Baltimore, Maryland, USA.
Shi
Leiyu
L
D002648:Child; D002662:Child Health Services; D003191:Comprehensive Health Care; D006296:Health Services / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006760:Hospitalization; D006801:Humans; D007348:Insurance, Health; D011320:Primary Health Care; D012959:Socioeconomic Factors; D014481:United States