Components of the Medical Home: Access and Care Coordination
An important component of the medical home is children’s access to primary and preventive care, consistent care when they are sick, access to referrals when they are needed, and support to help to assure that the various services they receive are coordinated.
These criteria were met for the majority of children. Overall, 93.2 percent were reported to have a regular source of sick care, 92.2 percent had a personal doctor or nurse, and 82.3 percent had no problems obtaining referrals when needed. The criterion that was met for the lowest percentage of children was the receipt of effective care coordination services, when needed, which was reported for 68.8 percent of children. Overall, 75.9 percent of children received care that met all four of these criteria. These percentages did not vary substantially across locations, except that children in rural areas were slightly less likely to report problems obtaining needed referrals.
Nearly all children with special health care needs in all locations also had a regular source of sick care and a personal doctor or nurse. CSHCN in urban areas were less likely than those in small rural areas to have no problems obtaining referrals: 77.4 percent were reported not to have referral problems, compared to 83.2 percent of CSHCN in small rural areas. Care coordination is a greater challenge for CSHCN in urban areas as well, with 58.5 percent reporting that they received effective care coordination services, compared to 64.2 percent of those in small rural areas.