A Review of the Evidence for the Medical Home for Children With Special Health Care Needs

Authors, Primary Homer,C. J.;Klatka,K.;Romm,D.;Kuhlthau,K.;Bloom,S.;Newacheck,P.;Van Cleave,J.;Perrin,J. M.
Title Primary A Review of the Evidence for the Medical Home for Children With Special Health Care Needs
Periodical Full Pediatrics
Pub Year 2008
Volume 122
issue 4
Start Page 922-937
Abstract CONTEXT: The receipt of health care in a medical home is increasingly touted as a fundamental basis for improved care for persons with chronic conditions, yet the evidence for this claim has not been systematically assessed. OBJECTIVE: Our goal was to determine the evidence for the federal Maternal and Child Health Bureau recommendation that children with special health care needs receive ongoing comprehensive care within a medical home. METHODS: We searched the nursing and medical literature, references of selected articles, and requested expert recommendations. Search terms included children with special health care needs, medical home-related interventions, and health-related outcomes. Articles that met defined criteria (e.g., children with special health care needs, United States-based, quantitative) were selected. We extracted data, including design, population characteristics, sample size, intervention, and findings from each article. RESULTS: We selected 33 articles that reported on 30 distinct studies, 10 of which were comparison-group studies. None of the studies examined the medical home in its entirety. Although tempered by weak designs, inconsistent definitions and extent of medical home attributes, and inconsistent outcome measures, the preponderance of evidence supported a positive relationship between the medical home and desired outcomes, such as better health status, timeliness of care, family centeredness, and improved family functioning. CONCLUSIONS: The evidence provides moderate support for the hypothesis that medical homes provide improved health-related outcomes for children with special health care needs. Additional studies with comparison groups encompassing all or most of the attributes of the medical home need to be undertaken.
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Reference Type(s) Journal Article
Topic Tag(s) Outcomes
Special Population(s) Children with Special Needs
Case Study No
Commentary/Opinion Piece No
Historical Publication No
Key/Foundational Article Yes
Literature Review Yes
Article Rating No
Summary of Article Rating No