Relationship Between Presence of a Reported Medical Home and Emergency Department Use Among Children With Asthma

Abstract

This study examined data from the 2005-2006 National Survey of Children with Special Health Care Needs to assess the relationship among children with asthma between a reported medical home and emergency department (ED) use. The authors used 21 questions to measure 6 medical home components: personal doctor/nurse, family-centered, compassionate, culturally effective and comprehensive care, and effective care coordination. Weighted zero-inflated Poisson regression analyses assessed the independent effects of having a medical home on annual number of child ED visits while controlling for child and parental characteristics, and the differential likelihood of securing a medical home. Nearly half (49.9%) of asthmatic children had a medical home. Receiving primary care in a medical home was associated with fewer ED visits (incidence rate ratio = 0.93; 95% confidence interval = 0.89-0.97). A medical home in which physicians and parents share responsibility for ensuring that children have access to needed services may improve child and family outcomes for children with asthma.

Associations Between Practice-Reported Medical Homeness and Health Care Utilization Among Publicly Insured Children

“…In the general pediatric population, parent-reported care in a medical home has been associated with increased receipt of well-child care, 7-9 decreased emergency department (ED) use, 7,8 and no differences in hospitalizations. 8 In children with chronic conditions, parent-reported care in a medical home has been associated with no differences in receipt of preventive care, 10,11 mixed results for ED visits, 10,12,13 and no differences in hospitalizations. 10 Two published studies that have examined the relationship between practice-reported PCMH measures and health care utilization by children also show mixed results.…”

The Asthma Awareness Patch Program for Girl Scouts: An Evaluation of Educational Effectiveness

“…To demonstrate the value of community based health services for patients with asthma or of asthma self-management programs, it is of value to report healthcare resource utilization (ie, emergency room visits, hospital readmissions) as a program outcome measure. [12][13][14][15] Although the length of this asthma awareness program was relatively short, its effect on asthma knowledge was profound. Program participants realized statistically significant improved post-test scores (P Ͻ .001).…”

How Low-Income Residents Decide Between Emergency and Primary Health Care for Non-Urgent Treatment

“…Overcrowded EDs at safety net hospitals-that is, hospitals committed to serving those with low incomes, no insurance, and who have difficulty receiving treatment elsewhere (Dewan & Sack, 2008)-are indicative of a failure of the health system to adequately serve disadvantaged communities. Increased access to primary health care services reduces use of EDs for non-emergencies (Roby et al, 2010;Wang, Villar, Mulligan, & Hansen, 2005), use of EDs for emergency treatment of chronic diseases (Diedhiou, Probst, Hardin, Martin, & Xirasagar, 2010), and overall health care costs (Guo, Wade, Pan, & Keller, 2010). Perhaps most importantly, increased primary care access improves total patient health (Hurley, Freund, & Taylor, 1989;Kasper, 1987).…”