title: The patient-centered medical home, practice patterns, and functional outcomes for children with attention deficit/hyperactivity disorder.
abstract: OBJECTIVE
  To determine whether children with attention deficit/hyperactivity disorder (ADHD) receive care in a patient-centered medical home (PCMH) and how that relates to their ADHD treatment and functional outcomes.
  
  
  METHODS
  Cross-sectional analysis of the 2007 National Survey for Children's Health, a nationally representative survey of 91,642 parents. This analysis covers 5169 children with parent-reported ADHD ages 6-17. The independent variable is receiving care in a PCMH. Main outcome measures are receiving ADHD medication, mental health specialist involvement, and functional outcomes (difficulties with participation in activities, attending school, making friends; having problem behaviors; missed school days; and number of times parents contacted by school).
  
  
  RESULTS
  Only 44% of children with ADHD received care in a PCMH. Children with ADHD receiving care in a PCMH compared with those who did not were more likely to receive medication for ADHD (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.1-1.9); less likely to have mental health specialist involvement (OR, 0.6; 95% CI, 0.4-0.7); less likely to have difficulties participating in activities (OR, 0.6; 95% CI 0.4-0.8), making friends (OR, 0.6; 95% CI, 0.5-0.9), and attending school (OR, 0.4; 95% CI, 0.3-06); less likely to have problem behaviors (OR 0.6; 95% CI 0.5-0.9); had fewer missed school days (β = -1.5, 95% CI -2.4 to -0.5); and parents were contacted by school less frequently (β = -0.2, 95% CI -0.3 to -0.1).
  
  
  CONCLUSIONS
  For children with ADHD, receiving care in a PCMH is associated with practice pattern change and better outcomes. The PCMH may represent a promising opportunity to improve quality of care and outcomes for children with ADHD.
authors.affiliation: Division of General Pediatrics, Children's Hospital Boston, 300 Longwood Avenue, Boston, Massachusetts 02115, USA. sara.toomey@childrens.harvard.edu
authors.forename: Sara L
authors.initials: SL
authors.lastname: Toomey
authors.forename: Eugenia
authors.initials: E
authors.lastname: Chan
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Ratner
authors.forename: Mark A
authors.initials: MA
authors.lastname: Schuster
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D018802:Patient-Centered Care / Q000379:methods / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians'; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology