Date: 06 Dec 2011
Factors Associated with a Medical Home Among Children with Attention-Deficit Hyperactivity Disorder
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Providing a medical home to children with Attention-Deficit Hyperactivity Disorder (ADHD) is challenging. Little is known about the factors associated with having a medical home for these children, or how comorbidities affect having a medical home. Our study aims are: (1) identify factors associated with having a medical home and five sub-components of a medical home and (2) determine the effect of medical home on several outcomes for children with ADHD. The sample included 5,495 children with ADHD from the 2007 National Survey of Children’s Health. Descriptive and multivariate analyses were conducted. Children with ADHD alone and children with ADHD plus a physical diagnosis had greater frequencies of having a medical home, or meeting the five sub-components, than children with ADHD plus a mental diagnosis. Multivariate results show that children with ADHD plus a physical and/or mental comorbidity were 24–63% more likely to be without a medical home compared to children with only ADHD. Having a medical home also had a bearing on several child health outcomes. Having a medical home was significantly associated with being less likely to have an unmet health need and having fewer missed school days; but also being less likely to have received needed mental health care (P < .05). Our results suggest that there are differences in parent’s perceptions of receiving care among children with ADHD. Pediatric medical home projects and policies should acknowledge that children with ADHD often have comorbidities making their care more complex. These complexities should be addressed during practice transformation and setting reimbursement policies.
Centers for Disease Control and Prevention. (2010, November 12). Increasing prevalence of parent-reported attention-deficit hyperactivity disorder among children- United States, 2003 and 2007. Morbidity and Mortality Weekly Report, 59(44), 1439–1443.
Blumberg, S. J., Olson, L., Frankel, M., et al. (2001). Design and operation of the national survey of children with special health care needs. Vital Health Stat 1, 2003(41), 1–136.
Diagnostic and Statistical Manual of Mental Disorders, Ed. IV, (DSM-IV). (1994). ADHD is a disruptive behavior disorder characterized by the presence of a set of chronic and impairing behavior patterns that display abnormal levels of inattention, hyperactivity, or their combination.
American Academy of Pediatrics, Medical Home Initiatives for Children with Special Needs Project Advisory Committee. (2004). Policy statement: organizational principles to guide and define the child health care system and/or improve the health of all children. Pediatrics, 113(5), 1545–1547.
U.S. Department of Health and Human Services. (2008, December). Health resources and services administration. Maternal and child health bureau. Recommendations for improving access to pediatric subspecialty through the medical home. Available at http://mchb.hrsa.gov/FinalRecommendationsofPediatricSubspecialty.htm, Accessed January 1, 2011.
American Academy of Family Physicians; American Academy of Pediatrics; American College of Physicians; American Osteopathoc Association. (2007, February). Joint principles of the patient-centered medical home. Available at www.pcpcc.net/content/joint-principles-patient-centered-medical-home. Accessed January 1, 2011.
US Department of Health and Human Services: Healthy People. (2010). Objectives for improving health (Vol. II, conference Ed.). Washington, DC: Health Resources and Services Administration; 2000.
Toomey, S. L., Homer, C. J., & Finkelstein, J. A. (2010). Comparing medical homes for children with ADHD and asthma. Academy of Pediatrics, 10(1), 56–63.
Blumberg, S. J., Foster, E. B., Frasier, A. M., et al. Design and operations of the National Survey of Children’s Health, 2007. National Center for Health Statistics. Vital Health Statistics, Series 1.
Statistical Analysis Software for Professionals, Release 9. (2010). Available at: http://www.stata.com/products/overview.html. Accessed July 15, 2010.
Crabtree, B. F., Miller, W. L., McDaniel, R. R., et al. (2009). A survivor’s guide for primary care physicians. Journal of Family Practice, 58(8), E1.PubMed
Crabtree, B. F., Nutting, P. A., Miller, W. L., et al. (2010). Summary of the National Demonstration Project and recommendations for the patient-centered medical home. The Annals of Family Medicine, 8(Suppl 1), S80–S90.CrossRef
Stille, C. J., Jerant, A., Bell, D., et al. (2005). Coordinating care across disease, settings, and clinicians: A key role for the generalist in practice. Annals of Internal Medicine, 142, 700–708.PubMed
Strickland, B., McPherson, M., Weissman, G., et al. (2004). Access to the medical home: Results of the national survey of children with special health care needs. Pediatrics, 113, 1485–1498.PubMed
National Academy for State Health Policy. (2011). About ABCD; Illinois. http://www.nashp.org/abcd-state/92 Accessed January 1, 2011.
- Factors Associated with a Medical Home Among Children with Attention-Deficit Hyperactivity Disorder
Maternal and Child Health Journal
Volume 16, Issue 9 , pp 1771-1778
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Medical home
- Child health outcomes
- Industry Sectors
- Author Affiliations
- 1. Department of Health Outcomes and Policy, University of Florida, 1329 SW 16th Street, Room 5130, Gainesville, FL, 32610, USA
- 2. Rehabilitation Outcomes Research Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, 32610, USA
- 3. Department of Pediatrics, University of Florida, Gainesville, FL, 32610, USA