Special Needs

Since the late 1960’s, the concept of a medical home has evolved from a place to store medical records for children and youth with special health care needs to a coordinated approach to providing health care¹. The medical home engages the patient, their family, and providers in taking responsibility for a child’s health care. The medical home knows each patient, and maintains organized records of their care that are used to ensure timely scheduling of routine wellness and preventive care visits. The medical home also helps to coordinate comprehensive care for patients by making referrals to any needed specialists outside of the medical home, including emotional or behavioral health care. Twenty-four seven access to office staff is ensured through systems such as an answering service or 24-hour nurse line.

In addition to keeping records of care that a child or youth with special health care needs (CYSHCN) receives in their primary care medical home, records are also obtained from any providers that the medical home refers a patient to. This allows the medical home to have the most up to date and comprehensive picture of a CYSHCN’s health as possible. A medical home may also develop a plan of care to address ongoing health concerns and effectively manage care, when appropriate².

Having a medical home is associated with improved health outcomes, such as lower rates of emergency room visits, hospitalizations, unmet needs, and delaying or going without care. It is also associated with improved family satisfaction, including less out-of-pocket spending, decreased missed workdays and parental worry, and increased ability for families to meet day-to-day demands of parenthood^{3, 4}.

Resources

1. Sia, C., Tonniges, T. F., Osterhus, E., & Taba, S. (2004). History of the medical home concept. Pediatrics, 113(Supplement 4), 1473-1478.
2. West Virginia Children's Health Insurance Program (WV CHIP). (2010, July). The Importance of a Medical Home. Retrieved from http://www.chip.wv.gov/SiteCollectionDocuments/SPDJuly2010-Med%20Home.pdf
3. Strickland, B. B., Jones, J. R., Ghandour, R. M., Kogan, M. D., & Newacheck, P. W. (2011). The medical home: health care access and impact for children and youth in the United States. Pediatrics, peds-2009.
4. Strickland, B., McPherson, M., Weissman, G., Van Dyck, P., Huang, Z. J., & Newacheck, P. (2004). Access to the medical home: results of the National Survey of Children with Special Health Care Needs. Pediatrics, 113(Supplement 4), 1485-1492.