title: Perceptions of the medical home by parents of children with chronic illnesses.
abstract: OBJECTIVE
  The patient-centered medical home (PCMH) strives to improve the quality of care in the primary care setting. Recently, certification programs for patient-centered coordinated care have expanded to subspecialty care. Children with chronic conditions are particularly in need of patient-centered and coordinated care. Our objective was to compare parent perceptions of PCMH elements at primary care and specialty practices for children receiving specialty care.
  
  
  METHODS
  Cross-sectional survey study.
  
  
  METHODS
  We surveyed the parents of children returning for specialty care in a hospital-based pediatric subspecialty clinic on the presence of National Committee for Quality Assurance (NCQA) PCMH elements in their primary care practice and in their main specialty care practice.
  
  
  RESULTS
  More parents perceived good appointment access at primary care practices than they did at specialty practices (93% vs 87%, respectively; P <.001). They perceived good care coordination and referral follow-up both at primary care and specialty practices (89% vs 88% and 92% vs 92%, respectively). However, parents less frequently perceived the presence of 7 other PCMH elements at primary care practices compared with specialty practices; these included appointment and tests due reminders, distributing handouts, electronic prescribing, sharing test results, surveying experiences, and e-mail capability.
  
  
  CONCLUSIONS
  Despite an emphasis on PCMHs in primary care settings, parents of children seeking specialty care are more likely to perceive the presence of NCQA PCMH elements in specialty rather than primary care clinics. Future PCMH efforts should address parents' perceptions and interpretations of these services.
authors.affiliation: Division of General Pediatrics and Adolescent Medicine, University of North Carolina, Department of Pediatrics, 231 MacNider Building, CB #7225, Chapel Hill, NC 27599-7220. E-mail: voemily@med.unc.edu.
authors.forename: Emily B
authors.initials: EB
authors.lastname: Vander Schaaf
authors.forename: Elisabeth P
authors.initials: EP
authors.lastname: Dellon
authors.forename: Rachael A
authors.initials: RA
authors.lastname: Carr
authors.forename: Neal A
authors.initials: NA
authors.lastname: deJong
authors.forename: Asheley C
authors.initials: AC
authors.lastname: Skinner
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Steiner
mesh_terms: D002648:Child; D002908:Chronic Disease / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D018802:Patient-Centered Care; D011320:Primary Health Care; D011785:Quality Assurance, Health Care; D011795:Surveys and Questionnaires