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, are sensitive to their values and customs, provide any information they need, and make the family feel like a partner in their child’s care
A child is defined as having a medical home if his or her care was reported to meet all of these criteria. Overall, the care of 54.4 percent of children met this standard. This proportion varies substantially by the race and ethnicity of the child: 65.7 percent of non-Hispanic White children received care from a medical home, compared to 44.7 percent of non-Hispanic Black children, 50.5 percent of non-Hispanic children of other races, and 37.2 percent of Hispanic children. Children with private insurance are also the most likely to receive their care from a medical home: 64.0 percent of privately-insured children were reported to have a medical home, compared to 43.9 percent of children with public insurance and 27.8 percent of uninsured children.
A medical home is particularly important for children with special health care needs (CSHCN), who are more likely to require specialized care and services, follow-up, and care coordination. Of CSHCN, 46.8 percent were reported to have a medical home, compared to 56.3 percent of children without special health care needs.