title: The impact of the medical home on access to care for children with autism spectrum disorders.
abstract: Children with autism spectrum disorders (ASD) experience difficulty accessing health care services. Using parent-reported data from the 2009-2010 National Survey of Children with Special Health Care Needs, we examined whether having a medical home reduces unmet need for specialty care services for children with ASD (n = 3,055). Descriptive statistics and Chi square tests identified sample characteristics and examined the relationship between unmet needs and a standardized measure of medical home. Logistic regression models explored the individual impact of demographic, condition-specific and medical home variables on unmet need. Parents reported that nearly all children had a need for specialty services, 36 % had an unmet need, and 23.9 % had a medical home. Children who had fewer unmet needs were more likely to have received family-centered and coordinated care through a medical home, and this relationship remained significant even when demographic and condition-specific variables were taken into account. These findings suggest ways to improve access to care for children with ASD through enhanced family-centered and coordinated care within the medical home.
authors.affiliation: Department of Health Sciences, University of Missouri, 510 Clark Hall, Columbia, MO, USA, cheakzamoran@missouri.edu.
authors.forename: Nancy C
authors.initials: NC
authors.lastname: Cheak-Zamora
authors.forename: Janet E
authors.initials: JE
authors.lastname: Farmer
mesh_terms: D000293:Adolescent; D002648:Child; D002659:Child Development Disorders, Pervasive; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D018802:Patient-Centered Care / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology