A medical home is a source of ongoing, comprehensive, coordinated, family-centered care in the child’s community.1 Child health care professionals and families agree that medical homes provide important benefits to children and youth with special health care needs.

The medical home can and should provide preventive services, immunizations, growth and developmental assessments, appropriate screening, health care supervision, and counseling for patients and their families about health and psychosocial issues. The medical home also can and should ensure that children have continuity of care from visit to visit, from infancy through transition into adulthood. In addition, the medical home must be supported to provide care coordination services so that each family and the range of professionals serving them work together as an organized team to implement a specific care plan and to address issues as they arise.

Collaboration between the primary, specialty, and subspecialty providers to establish shared management plans in partnership with the child and family, and to clearly articulate each other’s role, is a key component of the medical home concept. Equally key is the partnership between the primary care provider and the broad range of other community providers and programs serving CSHCN and their families. The medical home concept includes the responsibility of primary care providers to become knowledgeable about all the community services and organizations families can access.

The presence of a medical home was evaluated using a series of questions from the NS-CSHCN: whether the child has a personal doctor or nurse, whether he or she has a usual source of sick and well-child care; whether the child has had problems obtaining needed referrals; whether the family is satisfied with doctors’ communication with each other and with the child’s school and other systems; whether the family gets help coordinating the child’s care if needed; whether the doctor spends enough time with the child; whether the doctor listens carefully to the parent; whether the doctor is sensitive to the family’s customs; whether the doctor provides the family with enough information; and whether the parent feels like a partner in the child’s care.

1 American Academy of Pediatrics, Medical Home Initiatives for Children With Special Needs Project Advisory Committee. The medical home. Pediatrics. 2002;110(1 pt 1): 184–186 Return to text.

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