Most kids with special healthcare needs still aren't receiving 'patient-centered medical home' care

The "patient-centered medical home" (PCMH) approach is an important tool for providing coordinated care for the millions of American children with special healthcare needs. But most of these special-needs children don't have access to care consistent with the PCMH approach, reports a study in the October issue of Medical Care. The journal is published in the Lippincott portfolio by Wolters Kluwer.Despite extensive efforts over more than a decade, more than two-thirds of children with special healthcare needs aren't receiving "PCMH-concordant" care, according to the study by Mónica Pérez-Jolles, PhD, of University of Southern California and Kathleen C. Thomas, PhD, MPH, of University of North Carolina at Chapel Hill. Inequities in PCMH-concordant care are more common in certain subgroups, including children with higher functional impairment.

More Progress Needed in Providing PCMH Care for Kids with Special Needs Children with special healthcare needs are those with "a diagnosis of mental illness and/or the presence of a chronic physical or developmental condition that requires a higher use and range of health services compared to the general population." A national survey estimated that about 15 percent of children have special healthcare needs, and that 23 percent of US families have at least one child with special needs.

Because of their complex needs for healthcare and other services, these children are at risk for fragmented care or duplication of services. The PCMH approach - focused on delivering care that is accessible, family-centered, coordinated, comprehensive, culturally competent, compassionate, and high-quality - is an important part of efforts to improve outcomes for children with special healthcare needs.

In 2002, the American Academy of Pediatrics issued a statement endorsing the PCMH approach for children with special healthcare needs, stating that "every child deserves a medical home." Drs. Pérez-Jolles and Thomas write, "This study sought to elucidate how much progress have we made on that promise."

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