title: The medical home: relationships with family functioning for children with and without special health care needs.
abstract: OBJECTIVE
  In this study we tested the association of the medical home with family functioning for children without and with special health care needs (CSHCN).
  
  
  METHODS
  We used data from the 2007 National Survey of Children's Health to run multivariate logistic regressions to test the association between having a medical home and family functioning (difficulty with parental coping, parental aggravation, childcare/work issues, and missed school days). We further assessed interactions of CSHCN status with having a medical home.
  
  
  RESULTS
  In adjusted analysis, parents of children with a medical home were less likely to report difficulty with parental coping (odds ratio [OR] 0.26 [0.19-0.36]), parental aggravation (OR 0.54 [0.45-0.65]), childcare/work issues (OR 0.72 [0.61-0.84]), and missed school days (OR 0.87[0.78-0.97]) for their children than those without a medical home. Using interaction terms, we found that for most outcomes, the medical home had a greater association for CSHCN compared with healthy peers, with odds ratios ranging 0.40 (CI 0.22-0.56) for parental aggravation to 0.67 (CI0.52-0.86) for missed school days.
  
  
  CONCLUSIONS
  We show that the medical home is associated with better family functioning. All children may benefit from receiving care in a medical home, but CSHCN, who have greater needs, may particularly benefit from this enhanced model of care.
authors.affiliation: Massachusetts General Hospital, MassGeneral Hospital for Children, Center for Child and Adolescent Health Policy, Harvard Medical School, Boston, MA 02114, USA. aarauz@partners.org
authors.forename: Alexy D
authors.initials: AD
authors.lastname: Arauz Boudreau
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Van Cleave
authors.forename: Sangeeth K
authors.initials: SK
authors.lastname: Gnanasekaran
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Kurowski
authors.forename: Karen A
authors.initials: KA
authors.lastname: Kuhlthau
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D019988:Children with Disabilities / Q000706:statistics & numerical data*; D005192:Family Health / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000523:psychology*; D018802:Patient-Centered Care / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000706:statistics & numerical data*