A survey assessing the presence of "medical home" for adults with disabilities in Connecticut.
BACKGROUND
The medical home model has been recommended as the best design for healthcare management for individuals with disabilities by the American Academy of Pediatrics and the American Academy of Family Physicians. As set forth by these guidelines, a medical home contains the following elements: access to health care, usual source of care, personal doctor or nurse, referrals for specialty care, coordinated care, andperson-centered care.


OBJECTIVE
This study aimed to gather information from adults with disabilities in Connecticut, and the barriers to achieving the medical home model. The study focused on each of the components that make up the medical home model definition.


METHODS
An adultwith a disabilitywas defined as a person 18 years or older with any physical or mental disability that significantly impacted one or more major life activities, as defined by the Americans with Disabilities Act. The adults with disabilities were recruited by email through a variety of list servers and flyers that were mailed to employers of people with disabilities. The study consisted of 88 adults with disabilities who were interviewed via telephone with a 54-item survey that was developed based on the research of medical home models.


RESULTS
The most common types of disabilities represented were physical (51%), psychiatric (28%), and neurological (24%). The results ofthe study found that 22% of participants were found to have access to health care, 92% of participants reported they had a usual place they go to receive health care, 77% of participants reported having no problems with the process of referrals, 37% of participants were found to have adequate coordinated care, and 90% of participants were identified as having person-centered care.


CONCLUSIONS
Overall, only 7% of participants met the criteria for all aspects of the medical home model. The conclusions drawn from this study indicate a need for increased access to health care, more efficiently designed coordinated care, and more accessible referrals to specialists for adults with disabilities, with access being the largest barrier to adequate health care.
Bruder
Mary Beth
MB
School of Medicine, Department of Pediatrics, University of Connecticut Health Center, USA.
Mogro-Wilson
Cristina
C
Kerins
Gerard J
GJ
D000293:Adolescent; D000328:Adult; D003237:Connecticut / Q000453:epidemiology; D003266:Continuity of Patient Care / Q000706:statistics & numerical data; D006233:Persons with Disabilities; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D018802:Patient-Centered Care / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D055815:Young Adult