title: Access to patient-centered medical home among Ohio's Children with Special Health Care Needs.
abstract: Medical homes deliver primary care that is accessible, continuous, comprehensive, family centered, coordinated, compassionate and culturally effective. Children with special health care needs (CSHCN) require a wide range of support to maintain health, making medical home access particularly important. We sought to understand independent risk factors for lacking access. We analyzed Ohio, USA data from the National Survey of Children with Special Health Care Needs (2005-2006). Among CSHCN, 55.6% had medical home access. The proportion achieving each medical home component was highest for having a personal doctor/nurse and lowest for receiving coordinated care, family-centered care and referrals. Specific subsets of CSHCN were significantly and independently more likely to lack medical home access: Hispanic (AOR=3.08), moderate/high severity of difficulty (AOR=2.84), and any public insurance (AOR=1.60). Efforts to advance medical home access must give special attention to these CSHCN populations and improvements must be made to referral access, family-centered care, and care coordination.
authors.affiliation: Ohio Department of Health, State Epidemiology Office, USA. elizabethj.conrey@odh.ohio.gov
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Conrey
authors.forename: Dazar
authors.initials: D
authors.lastname: Seidu
authors.forename: Norma J
authors.initials: NJ
authors.lastname: Ryan
authors.forename: Dj Sam
authors.initials: DjS
authors.lastname: Chapman
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019988:Children with Disabilities; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D008297:Male; D009820:Ohio; D018802:Patient-Centered Care; D013223:Statistics as Topic