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Health Service and Functional Measures of Benefit of a Medical Home in Children with Autism

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Abstract

Objectives

A medical home is a model of patient-centered, comprehensive care recommended by the American Academy of Pediatrics for all children. The aims of this study were (1) to determine if the presence of a medical home is associated with improved health service outcomes of children with autism, and (2) to determine if the presence of a medical home is associated with improved key functional outcomes in children with autism.

Methods

This study used data from the 2016–2017 National Survey of Children’s Health. We used a medical home construct of 14 survey questions as the main independent variable in logistic regression models estimating cross-sectional association, and also evaluated the interaction between medical home and demographic and household characteristics, including race, income, household composition, and autism severity in regression for outcomes.

Results

Overall, the presence of a medical home was associated with increased parent reporting of shared health care decision-making, receipt of preventive pediatric care, and reduced frustration in accessing services. Some functional outcomes were also positively associated with the presences of a medical home in children with parent-reported mild autism symptoms; children who had a medical home visited the ED less often than children without a medical home. This did not persist for children with moderate or severe parent-rated autism.

Conclusions for practice

Based on parent-reported, cross-sectional data from a large, nationally representative sample of families with a child with autism, the presence of a medical home was positively associated with some improved health services and functional outcomes.

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Abbreviations

ASD:

Autism spectrum disorders

CDC:

Centers for disease control and prevention

CSHCN:

Children with special health care needs

NPL:

National poverty level

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Funding

This project was done with no specific financial support.

Author information

Authors and Affiliations

  1. Drexel University A.J. Drexel Autism Institute, 3020 Market St. Suite 560, Philadelphia, PA, USA

    Jessica Rast & Jennifer Plumb

  2. The Pennsylvania State University College of Health and Human Development, State College, PA, USA

    Craig Newschaffer

  3. St. Christopher’s Hospital for Children, Philadelphia, PA, USA

    Renee Turchi

  4. Drexel University Dornsife School of Public Health, Philadelphia, PA, USA

    Renee Turchi

Authors
  1. Jessica Rast
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  2. Craig Newschaffer
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  3. Renee Turchi
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  4. Jennifer Plumb
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Contributions

JR conceptualized the study, ran analysis, and wrote a rough draft of the submission. She incorporated many edits and approved the final version for submission. CN helped with conceptualization of the study, as well as providing in-depth support for analytic activities and editing of the rough draft. He provided a critical role in the analysis and the drafting of the methods and results sections. He approved the final manuscript as submitted. RT conceptualized the study and provided critical insight into the existing literature on medical home and other related concepts. She provided a critical link to the practical relevance of these findings, and heavily drafted these portions of the submission. Beyond drafting these sections, she was integral to the organization of the submission as a whole, and editing and to improve all sections. She approved the final manuscript as submitted. JP conceptualized the study, provided insight into the link between findings and practice, and helped with critically examining these sections. She approved the final manuscript as submitted.

Corresponding author

Correspondence to Jessica Rast.

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Conflict of interest

The authors have no conflicts of interest relevant to this article to disclose. The authors have no financial relationships relevant to this article to disclose.

Ethical Approval

This study was declared exempt from humans subject research by the Drexel University Institutional Review Board.

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Rast, J., Newschaffer, C., Turchi, R. et al. Health Service and Functional Measures of Benefit of a Medical Home in Children with Autism. Matern Child Health J 25, 1156–1163 (2021). https://doi.org/10.1007/s10995-021-03150-2

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  • DOI: https://doi.org/10.1007/s10995-021-03150-2

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