title: Factors associated with a medical home among children with Attention-Deficit Hyperactivity Disorder.
abstract: Providing a medical home to children with Attention-Deficit Hyperactivity Disorder (ADHD) is challenging. Little is known about the factors associated with having a medical home for these children, or how comorbidities affect having a medical home. Our study aims are: (1) identify factors associated with having a medical home and five sub-components of a medical home and (2) determine the effect of medical home on several outcomes for children with ADHD. The sample included 5,495 children with ADHD from the 2007 National Survey of Children's Health. Descriptive and multivariate analyses were conducted. Children with ADHD alone and children with ADHD plus a physical diagnosis had greater frequencies of having a medical home, or meeting the five sub-components, than children with ADHD plus a mental diagnosis. Multivariate results show that children with ADHD plus a physical and/or mental comorbidity were 24-63% more likely to be without a medical home compared to children with only ADHD. Having a medical home also had a bearing on several child health outcomes. Having a medical home was significantly associated with being less likely to have an unmet health need and having fewer missed school days; but also being less likely to have received needed mental health care (P < .05). Our results suggest that there are differences in parent's perceptions of receiving care among children with ADHD. Pediatric medical home projects and policies should acknowledge that children with ADHD often have comorbidities making their care more complex. These complexities should be addressed during practice transformation and setting reimbursement policies.
authors.affiliation: Department of Health Outcomes and Policy, University of Florida, 1329 SW 16th Street, Room 5130, Gainesville, FL 32610, USA. cak@ichp.ufl.edu
authors.forename: Caprice A
authors.initials: CA
authors.lastname: Knapp
authors.forename: Melanie
authors.initials: M
authors.lastname: Hinojosa
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Baron-Lee
authors.forename: Dan
authors.initials: D
authors.lastname: Fernandez-Baca
authors.forename: Ramon
authors.initials: R
authors.lastname: Hinojosa
authors.forename: Lindsay
authors.initials: L
authors.lastname: Thompson
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D002648:Child; D005191:Family Characteristics; D005260:Female; D006301:Health Services Needs and Demand; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D010043:Outcome and Process Assessment, Health Care; D010290:Parents / Q000523:psychology; D018802:Patient-Centered Care / Q000379:methods / Q000706:statistics & numerical data*; D010372:Pediatrics; D012720:Severity of Illness Index; D012959:Socioeconomic Factors