(SDAS) Using the National Survey of Children's Health to Examine Medical Home Effects on Asthma Hospitalizations for Vulnerable Children
Grantee: University of Southern California
Principal Investigator: Gregory D. Stevens
Project Number: R40MC07844
Project Date: 1/1/2007
Final Report
Age group(s)
- Perinatal/Infancy (0-12 months)
- Toddlerhood (13-35 months)
- Early Childhood (3-5 years)
- Middle Childhood (6-11 years)
- Adolescence (12-18 years)
Abstract
Researchers have previously linked certain medical home attributes to better child health outcomes. It remains unclear, however, whether having a medical home equally benefits the most vulnerable children (i.e., those most susceptible to poor health outcomes). New conceptual and empirical work has validated a method for measuring child vulnerability through the use of child risk profiles. These risk profiles have proven useful in understanding disparities in the receipt of primary care (and a medical home), but little is known about how risk profiles may moderate the linkage between having a medical home and child health outcomes. The proposed study examines whether the cardinal features of a medical home model contribute to a reduction in hospitalizations for asthma among children. Using the child risk profiles methodology, this study examines whether a medical home is equally beneficial for vulnerable children (i.e., those at higher risk for asthma hospitalizations). This study further examines the extent to which State-level policy variables such as Maternal and Child Health Bureau (MCHB) Title V funding allocations and primary health care professional shortages affects these relationships. This study uses publicly-available, nationally-representative data from the MCHB-sponsored 2003 National Survey of Children's Health (NSCH). Data are available on over 12,200 children ages 0 - 17 years who have been diagnosed with asthma. Six aspects of a medical home are measured: access, continuity, comprehensiveness, family-orientation, coordination, and cultural-competence. Understanding whether a medical home may help reduce asthma hospitalizations and whether this differs by child vulnerability level will provide guidance to policymakers considering policies to enhance access to high quality primary care for children. MCHB Research Priorities: The proposed project reflects three priorities of MCHB. First, the research addresses Strategic Research Issue #1 regarding public health service systems for maternal and child health populations, by examining the medical home model of care and its effects on health-related outcomes for vulnerable children. Second, the research addresses Strategic Research Issue # II regarding the elimination of health disparities, by examining what role a medical home may play in the remediation of disparities in asthma hospitalizations for vulnerable populations. Third, the proposed research addresses Strategic Research Issue # III regarding health services/systems to assure quality of care, by examining the impact of specific cardinal features of a medical home on health-related outcomes for children.<< Previous Next >>