Presence and characteristics of medical home and health services utilization among children with asthma.
BACKGROUND
Having a medical home is advocated by the National Association of Pediatric Nurse Practitioners and others, yet there is limited research that documents desired health benefits. We examine the presence of medical home characteristics and describe relationships between medical home and health services utilization in a national sample that includes children with asthma.


METHODS
Medical home is represented by: (a) the presence of a usual source of care (USC), (b) identification of a named person as USC, and (c) a 10-item index of other medical home characteristics. Health services utilization over a calendar year is measured by (a) emergency department visits for asthma, (b) wellness examination, and (c) rescue bronchodilator fill/refill. Analyses include chi-square and logistic regression.


RESULTS
A USC was reported for 95% of participants. Children with a USC were more likely to have a wellness examination (odds ratio, 2.10; 95% confidence interval, 1.15-3.81). Overall, 51% reported the USC to be a facility versus a named person. Identifying a person as the USC was related to higher scores on the 10-item medical home index but not to other outcomes.


CONCLUSIONS
Most parents were satisfied with the USC. Benefits of having a USC, but not necessarily a named person, appear in preventive actions.
Kieckhefer
Gail M
GM
Department of Family and Child Nursing, University of Washington, Seattle, WA 98195-7262, USA. gailmk@u.washington.edu
Greek
April A
AA
Joesch
Jutta M
JM
Kim
Hyoshin
H
Baydar
Nazli
N
D000041:Absenteeism; D000293:Adolescent; D001249:Asthma / Q000453:epidemiology / Q000628:therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D004363:Drug Utilization; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D010372:Pediatrics / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D001993:Bronchodilator Agents