Care Coordination and Unmet Specialty Care Among Children With Special Health Care Needs

Authors, Primary Arauz Boudreau,Alexy;Goodman,Elizabeth;Kurowski,Daniel;Perrin,James M.;Cooley,W. C.;Kuhlthau,Karen
Title Primary Care Coordination and Unmet Specialty Care Among Children With Special Health Care Needs
Periodical Full Pediatrics
Pub Year 2014
Volume 133
issue 6
Start Page 1046-1053
Abstract OBJECTIVES: Care coordination and the medical home may ensure access to specialty care. Children with special health care needs (CSHCN) have higher rates of specialty care use and unmet need compared with the general pediatric population. We hypothesized that care coordination, regardless of whether it was provided in a medical home, would decrease unmet specialty care needs among CSHCN and that the effect of care coordination would be greater among low-income families. METHODS: Secondary data analysis of participants in the 2009–2010 National Survey of CSHCN who reported unmet specialty care needs and for whom care coordination and medical home status could be determined (n = 18 905). Logistic regression models explored the association of unmet need with care coordination and medical home status adjusting for household income. RESULTS: Approximately 9% of CSHCN reported having unmet specialty care needs. Care coordination was associated with reduced odds of unmet specialty care need (without a medical home, odds ratio: 0.63, 95% confidence interval: 0.47–0.86; within a medical home, odds ratio: 0.22, 95% confidence interval: 0.16–0.29) with a greater reduction among those receiving care coordination within a medical home versus those receiving care coordination without a medical home. We did not find differences in the impact of care coordination by percentage of the federal poverty level. CONCLUSIONS: Care coordination is associated with family report of decreased unmet specialty care needs among CSHCN independent of household income. The effect of care coordination is greater when care is received in a medical home.
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Reference Type(s) Journal Article
Topic Tag(s) Access to Care;Care Coordination;Outcomes
Special Population(s) Children with Special Needs
Case Study No
Commentary/Opinion Piece No
Historical Publication No
Key/Foundational Article No
Literature Review No
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