Maternal and Child Health Research Program

Advancing Applied MCH Research

Improving Medical Homes for Children with Chronic Conditions

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Project Number: R40 MC 02502-03
Grantee: Massachusetts General Hospital
Department/Center: Center for Child & Adolescent Health Policy
Project Date: 03/01/2004

Final Report

Improving Medical Homes for Children with Chronic Conditions Final Report (PDF) Exit Disclaimer

Principal Investigator

James Perrin, M.D.
Professor of Pediatrics
50 Staniford Street, #901
Boston, MA  02114-2554
Phone: (617) 726-8716
Email: jperrin@partners.org

Age

  • Infancy (0-12 months)
  • Toddlerhood (1-2 years)
  • Early Childhood (3-5 years)
  • Middle Childhood (6-11 years)
  • Adolescence (12-18 years)

Abstract

OBJECTIVES: (1) To determine the effects of receiving care through a medical home with care coordination in community primary care settings on three main outcomes for families with children with special health care needs (CSHCN): access to care, satisfaction with care, and mental health of children and parents. A secondary aim is to describe how variations in care coordinators' roles may affect these outcomes. STUDY POPULATION: (1) Five new (to be named) primary care practices enrolling in the Massachusetts Medical Home Program (MMHP), an effort of the state health department to improve care for children with chronic conditions by placing state care coordinators in community pediatric practices; two comparison practices without coordinators; (2) 80-100 families with children with chronic conditions per intervention practice and 120 matched families from each of the 2 comparison practices. STUDY DESIGN: Quasi-experimental differences-in-differences examination of changes over one year in families newly enrolling in care coordination through the MMHP versus changes at same time in comparison practice families. Measures include: (1) access to care and met needs; (2) child and parent mental health measures; (3) satisfaction with care; (4) parent views of the care coordination process; and (5) sociodemographic and child health status data. The Medical Home Index (MHI) will assess practice changes in methods to provide chronic care over time. INTERVENTION: The Massachusetts Department of Public Health, through its Massachusetts Medical Home Project, places care coordinators in selected primary care practices to improve childhood chronic care management and help practices' evolution into medical homes for CSHCN. ANALYTIC METHODS: Linear regressions to determine effects on family outcomes, controlling for sociodemographic and child health status variables, of care coordination and whether parent reports of care coordination affect outcomes.

Publications

Listed is descending order by year published.

Lawson KA, Bloom SR, Sadof M, Stille C, Perrin JM. Care coordination for children with special health care needs: evaluation of a state experiment. Matern Child Health J. 2010 August 19. [Epub ahead of print] DOI 10.1007/s10995-016-0660-1.

Keywords

Special Health Care Needs, Medical Home, Mental Health & Wellbeing, Coordination of Services, Access to Health Care, Chronic Illness, Developmental Disabilities

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