A number of characteristics of high-quality health care for children can be combined into the concept of the medical home. As defined by the American Academy of Pediatrics, children’s medical care should be accessible, family-centered, continuous, comprehensive, coordinated, compassionate, and culturally effective. The survey included several questions that sought to measure whether a child’s health care met this standard:
- Whether the child has at least one personal doctor or nurse who knows him or her well and a usual source of sick care
- Whether the child has no problems gaining referrals to specialty care and access to therapies or other services or equipment
- Whether the family is very satisfied with the level of communication among their child’s doctors and other programs
- Whether the family usually or always gets sufficient help coordinating care when needed and receives effective care coordination
- Whether the child’s doctors usually or always spend enough time with the family, listen carefully to their concerns, were sensitive to their values and customs, provide any information they need, and make the family feel like a partner in their child’s care
- Whether an interpreter is usually or always available when needed.
A child was defined as having a medical home if his or her care is reported to meet all of these criteria. Overall, the care of 57.6 percent of children met this standard. This percentage was similar in urban and rural locations.
A medical home is particularly important for children with special health care needs (CSHCN), who were more likely to require specialized care and services, follow-up, and care coordination. In all locations, CSHCN were less likely than other children to receive their care from a medical home. The percentage of CSHCN who had access to a medical home ranged from 48.9 percent of urban children to 54.4 percent of children in small rural areas.