
			About Medhome

About Medical Home

What is a Medical Home?

A Medical Home is not a house, office, or hospital, but rather an approach to providing comprehensive primary care. In a medical home, a pediatric clinician works in partnership with the family/patient to assure that the medical and non-medical needs of the child/youth are met. Through this partnership, the clinician can help the family/patient access and coordinate specialty care, educational services, out-of-home care, family support, and other public and private community services that are important to the overall health of the child and family.

The American Academy of Pediatrics (AAP) describes the ideal Medical Home as one that provides "accessible, continuous, comprehensive, family centered, coordinated, compassionate, and culturally effective care." Though many Medical Home implementations focus on children with special health care needs, "every child deserves a Medical Home." AAP Policy Statements ([American: 2004], [Rushton: 2005], [Cooley: 2004], [Council: 2005])have codified the role of pediatricians and other primary care clinicians in providing comprehensive care for children with chronic and complex conditions and defined the Medical Home concept. A 2007 article emphasized the importance of care coordination in providing a medical home. [McAllister: 2007]

In 2007, the AAP, American Academy of Family Physicians, American College of Physicians, and American Osteopathic Association developed the Joint Principles of the Patient-Centered Medical Home. Key components that have particular applicability to pediatric settings include (from www.medicalhomeinfo.org):

Family-centered partnership: Trusting, collaborative, working partnership with families, respecting their diversity and recognizing that they are the constant in a child's life,
Community-based system: Family-centered, coordinated collaborations designed to promote the healthy development and well being of children and their families,
Transitions: Provision of high-quality, developmentally appropriate, health care services that continue uninterrupted as the individual moves along and within systems of services and from adolescence to adulthood, and
Value: A high-performance health care system requires appropriate financing to support and sustain medical homes that promote system-wide quality care with optimal health outcomes, family satisfaction, and cost efficiency.

Information about integrating the Medical Home concept into your practice is available through AAP Medical Home Training Programs & Materials and the Center for Medical Home Improvement, as well as throughout this MedHome Portal.

Who are Children and Youth with Special Health Care Needs?

Children and Youth with Special Health Care Needs (CYSHCN) are "those who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally." [McPherson: 1998] Studies have found the prevalence of children in the United States meeting these criteria to be 12.8% [van: 2004] to 15.6% [Newacheck: 2005]. The National Survey of Children with Special Health Care Needs 2005/2006 found 13.9% of the nation's and 11% of Utah's children met this definition of children with special health care needs. For information about the study and data from each state, see www.CSHCNdata.org.

For More Information:

Information about the Medical Home concept, implementation, and related topics, is available at the National Center of Medical Home Initiatives for Children with Special Health Care Needs web site, www.medicalhomeinfo.org, sponsored by the American Academy of Pediatrics. The site offers access to comprehensive information about national and local resources related to Medical Home and CSHCN.

The mission of the Center for Medical Home Improvement (www.medicalhomeimprovement.org) is to establish and support networks of parent/professional teams to improve the quality of primary care medical homes for children and youth with special health care needs and their families. Useful tools, assessments, and resources are available on their web site.

For more information about Medical Home and links to several other Medical Home web sites, see General Medical Home Info on the AAP's medicalhomeinfo site, where you will also find a comprehensive Medical Home Bibliography.

Authors

Author:

Chuck Norlin, 3/2008

Content Last Updated:

4/2008

Page Bibliography

American Academy of Pediatrics Medical Home Initiatives for Children With Special Needs Project Advisory Committee.
Policy statement: the Medical Home
Pediatrics. 2004;113(5 Suppl):1545-7. PubMed abstract / Full Text

Cooley WC.
Providing a primary care medical home for children and youth with cerebral palsy.
Pediatrics. 2004;114(4):1106-13. PubMed abstract / Full Text

Council on Children with Disabilities.
Care coordination in the medical home: integrating health and related systems of care for children with special health care needs.
Pediatrics. 2005;116(5):1238-44. PubMed abstract / Full Text

McAllister JW, Presler E, Cooley WC.
Practice-based care coordination: a medical home essential.
Pediatrics. 2007;120(3):e723-33. PubMed abstract

McPherson M, Arango P, Fox H, Lauver C, McManus M, Newacheck PW, Perrin JM, Shonkoff JP, Strickland B.
A new definition of children with special health care needs.
Pediatrics. 1998;102(1 Pt 1):137-40. PubMed abstract

Newacheck PW, Kim SE.
A national profile of health care utilization and expenditures for children with special health care needs.
Arch Pediatr Adolesc Med. 2005;159(1):10-7. PubMed abstract

Rushton FE Jr.
The pediatrician's role in community pediatrics.
Pediatrics. 2005;115(4):1092-4. PubMed abstract / Full Text

van Dyck PC, Kogan MD, McPherson MG, Weissman GR, Newacheck PW.
Prevalence and characteristics of children with special health care needs.
Arch Pediatr Adolesc Med. 2004;158(9):884-90. PubMed abstract

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