Characteristics of coordinated ongoing comprehensive care within a medical home in Maine.
OBJECTIVE
Access to coordinated, ongoing comprehensive care in a medical home (CCMH) is a national health objective and a federal performance measure. The National Survey of Children With Special Health Care Needs (National Survey of CSHCN) provides state level data on this Maternal Child Health Bureau performance measure. In Maine, only 60% of CSHCN received CCMH in 2001. Here we described characteristics of receiving comprehensive care in a medical home for CSHCN, in Maine.


METHODS
Data from the National Survey of CSHCN were used for the analysis. We examined associations between receiving CCMH and demographic factors, severity of a condition or problem, and having adequate insurance coverage for services in univariate and multivariate logistic regression models.


RESULTS
The distribution of children who received CCMH did not differ across gender, race, age, or poverty level. Children with adequate insurance were more likely to have received this care than those without adequate insurance and those with a more severe condition or problem were less likely to receive CCMH.


CONCLUSIONS
We found that receiving CCMH was positively related to adequate insurance, independent of poverty. We also found that CSHCN with more severe conditions have more unmet needs than those with less severe conditions. CSHCN programs, which have a responsibility to assure that CSHCN receive CCMH, must work to maximize insurance coverage. Programs can also work to raise awareness among providers of the complexity of CCMH and the role it plays in maximizing the health of the child and family.
Bureau of Health, Maine Department of Health and Human Services, 244 Water St., 11 SHS, 2nd floor, Augusta, Maine, 04333-0011, USA. kathy.l.tippy@maine.gov
Kathy
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Tippy
Katie
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Meyer
Richard
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Aronson
Toni
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Wall
D000293:Adolescent; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D003191:Comprehensive Health Care / Q000458:organization & administration*; D003625:Data Collection; D003710:Demography; D019988:Children with Disabilities; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019458:Insurance Coverage; D008281:Maine; D008297:Male; D012923:Social Class