title: Relationship between presence of a reported medical home and emergency department use among children with asthma.
abstract: This study examined data from the 2005-2006 National Survey of Children with Special Health Care Needs to assess the relationship among children with asthma between a reported medical home and emergency department (ED) use. The authors used 21 questions to measure 6 medical home components: personal doctor/nurse, family-centered, compassionate, culturally effective and comprehensive care, and effective care coordination. Weighted zero-inflated Poisson regression analyses assessed the independent effects of having a medical home on annual number of child ED visits while controlling for child and parental characteristics, and the differential likelihood of securing a medical home. Nearly half (49.9%) of asthmatic children had a medical home. Receiving primary care in a medical home was associated with fewer ED visits (incidence rate ratio = 0.93; 95% confidence interval = 0.89-0.97). A medical home in which physicians and parents share responsibility for ensuring that children have access to needed services may improve child and family outcomes for children with asthma.
authors.affiliation: South Carolina Public Health Consortium, Arnold School of Public Health, University of South Carolina, 800 Sumter Street, Suite 309, Columbia, SC 29208, USA. diedhiou@mailbox.sc.edu
authors.forename: Abdoulaye
authors.initials: A
authors.lastname: Diedhiou
authors.forename: Janice C
authors.initials: JC
authors.lastname: Probst
authors.forename: James W
authors.initials: JW
authors.lastname: Hardin
authors.forename: Amy B
authors.initials: AB
authors.lastname: Martin
authors.forename: Sudha
authors.initials: S
authors.lastname: Xirasagar
mesh_terms: D000293:Adolescent; D000465:Algorithms; D001249:Asthma / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006694:Holistic Health; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010348:Patient Care Team; D018802:Patient-Centered Care / Q000458:organization & administration*; D010817:Physician-Patient Relations; D016012:Poisson Distribution; D011320:Primary Health Care / Q000458:organization & administration; D011787:Quality of Health Care