Factors Associated with a Patient-Centered Medical Home Among Children with Behavioral Health Conditions

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• 作者：Caprice Knapp (1)
  Lindsey Woodworth (1)
  Daniel Fernandez-Baca (1)
  Jacqueline Baron-Lee (1)
  Lindsay Thompson (2)
  Melanie Hinojosa (1)
  
• 关键词：ADHD ; Autism ; Depression ; Medical home ; Child health outcomes ; Survey
• 刊名：Maternal and Child Health Journal
• 出版年：2013
• 出版时间：November 2013
• 年：2013
• 卷：17
• 期：9
• 页码：1658-1664
• 全文大小：
• 作者单位：Caprice Knapp (1)
  Lindsey Woodworth (1)
  Daniel Fernandez-Baca (1)
  Jacqueline Baron-Lee (1)
  Lindsay Thompson (2)
  Melanie Hinojosa (1)
  
  1. Department of Health Outcomes and Policy, University of Florida, 1329 SW 16th Street, Gainesville, FL, 32610, USA
  2. Department of Pediatrics, University of Florida, Gainesville, FL, USA
  
• ISSN：1573-6628

文摘

At some point in their lives, nearly one-half of all American children will have a behavioral health condition. Many will not receive the care they need from a fragmented health delivery system. The patient-centered medical home is a promising model to improve their care; however, little evidence exists. Our study aim was to examine the association between several behavioral health indicators and having a patient-centered medical home. 91,642 children? parents or guardians completed the 2007 National Survey of Children? Health. An indicator for patient-centered medical home was included in the dataset. Descriptive statistics, bivariate tests, and multivariate regression models were used in the analyses. Children in the sample were mostly Male (52?%), White (78?%), non-Hispanic (87?%), and did not have a special health care need (80?%). 6.2?% of the sample had at least one behavioral health condition. Conditions ranged from ADHD (6?%) to Autism Spectrum Disorder (ASD) (1?%). Frequency of having a patient-centered medical home also varied for children with a behavioral health condition (49?% of children with ADHD and 33?% of children with ASD). Frequency of having a patient-centered medical home decreased with multiple behavioral health conditions. Higher severity of depression, anxiety, and conduct disorder were associated with a decreased likelihood of a patient-centered medical home. Results from our study can be used to target patient-centered medical home interventions toward children with one or more behavioral health conditions and consider that children with depression, anxiety, and conduct disorder are more vulnerable to these disparities.