title: The relationship between the medical home and unmet needs for children with autism spectrum disorders.
abstract: The purpose of this study was to examine the relationship between having access to a medical home and unmet needs for specialty care services for children with autism spectrum disorders (ASD). Parents of children enrolled in a national autism registry were invited to complete an online Access to Care Questionnaire. The resulting sample consisted of 371 parents-child dyads. Bivariate and hierarchical regression analyses were conducted to determine whether having a medical home was associated with the number of unmet needs for specialty care. Less than one in five children with ASD had a medical home (18.9%). Nearly all parents reported that their child had a personal doctor or nurse as well as a usual source of care, but less than one-third received coordinated care (29.9%) and less than one-half received family-centered care (47.1%). Many children had unmet needs (63%), and the highest unmet need was for behavioral therapy. Having a medical home was associated with fewer unmet specialty care needs, even after demographic, child and family characteristics were taken into account. Children with ASD who have a medical home are more likely to have adequate access to needed services. Unfortunately, relatively few children have a medical home that includes family-centered and coordinated care. Enhancements in the delivery of primary care for children with ASD may make a real difference in access to needed specialty care services, potentially improving child and family outcomes.
authors.affiliation: Department of Health Psychology, University of Missouri, 421 Lewis Hall, Columbia, MO, 65211, USA, farmerje@health.missouri.edu.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Farmer
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Clark
authors.forename: Wayne A
authors.initials: WA
authors.lastname: Mayfield
authors.forename: Nancy
authors.initials: N
authors.lastname: Cheak-Zamora
authors.forename: Alison R
authors.initials: AR
authors.lastname: Marvin
authors.forename: J Kiely
authors.initials: JK
authors.lastname: Law
authors.forename: Paul A
authors.initials: PA
authors.lastname: Law
mesh_terms: D000293:Adolescent; D002648:Child; D002659:Child Development Disorders, Pervasive; D002675:Child, Preschool; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D008297:Male; D018802:Patient-Centered Care; D011795:Surveys and Questionnaires