Comprehensive Primary Care for Children With Special Health Care Needs in Rural Areas

Farmer, Janet E.; Clark, Mary Jo; Sherman, Ashley; Marien, Wendi E.; Selva, Thomas J.

doi:10.1542/peds.2004-0647

Cited by 78 publications

(95 citation statements)

References 33 publications

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“…12 Conversely, rates of visits to specialists have been demonstrated to decrease among CSHCN in medical homes. 22 This inconsistent association between the medical home and health-related outcomes for CSHCN highlights the need for additional studies. [23][24][25] Our study examines the association of care coordination, a key component of the medical home, with family-perceived unmet specialty care needs for CSHCN.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: Parents of children with special health care needs and low-income children report more unmet specialty care needs. Care coordination is associated with increased and decreased referrals to specialty care, but whether care coordination is related to unmet needs is unknown.WHAT THIS STUDY ADDS: Among children with special health care needs, care coordination is associated with lower odds of unmet specialty care needs regardless of whether care coordination was received within a medical home. This association was independent of household income. 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. Pediatrics

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Section: Discussionmentioning

confidence: 99%

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

et al. 2014

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“…Practices that develop a meaningful relationship with schools could benefit through improved bi-directional communication about symptoms, management, and treatment adherence. Specific to the PCMH, other studies suggest that the PCMH is positively associated with school engagement [8,9], ease of use of community services [10], improved access to specialists through referrals [11,12], and decreased need for social support [11]. Although insightful, most of these studies are quantitative and cannot comment on why linkages are difficult to develop.…”

Section: Introductionmentioning

confidence: 99%

Linking Primary Care to the Community: A Study of Pediatric Practices in Florida

Knapp

Madden²,

Sehovic³

et al. 2014

J Gen Pract

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“…12 There is a paucity of literature regarding the optimal model of care for the hospitalized CMC, barriers to delivering care to CMC, or pediatric hospitalists' perspectives on the best way to deliver care to these patients. Srivastava et al 13 clearly describe that the care for hospitalized CMC should be family-centered, coordinated, aimed at minimizing harm, and focused on issues affecting the "whole child" such as nutrition and functional limitations.…”

Section: Introductionmentioning

confidence: 99%

Pediatric Hospitalists’ Perspectives on the Care of Children With Medical Complexity

Adame

Rocha

Louden

et al. 2011

Hospital Pediatrics

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OBJECTIVE: The aims of this study were to identify pediatric hospitalists' perceived views of (1) barriers to delivering care to children with medical complexity (CMC) and (2) their preferred model of inpatient health care delivery for CMC. SUBJECTS:American Academy of Pediatrics Section on Hospital Medicine (AAP-SOHM) Listserv subscribers. METHODS:We conducted a cross-sectional survey of subscribers of the AAP-SOHM Listserv using the survey instrument SurveyMonkey®. Our survey was coadministered with a survey on pediatric hospitalist career satisfaction. RESULTS:The most signifi cant barriers to delivering care to CMC were (1) time constraints (89%), (2) inadequate postdischarge resources (75%), and (3) lack of evidence-based guidelines (64%). Although most pediatric hospitalists in an inpatient service currently care for both CMC and non-CMC patients (91%), only 25% perceive this to be the optimal service model for CMC. The majority of hospitalists (56%) believe that CMC are better served by either an inpatient service dedicated to CMC (30%) or comanaged with an inpatient consult service for CMC (26%). CONCLUSIONS:Identifying the perceived barriers to delivering care to CMC can assist pediatric hospitalists to design studies determining if care delivery is affected by these barriers. Most hospitalists care for CMC on the same service as uncomplicated patients, yet over half perceive that a different model of care delivery would better serve the needs of CMC.

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Comprehensive Primary Care for Children With Special Health Care Needs in Rural Areas

Cited by 78 publications

References 33 publications

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

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

Linking Primary Care to the Community: A Study of Pediatric Practices in Florida

Pediatric Hospitalists’ Perspectives on the Care of Children With Medical Complexity

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