The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #61044

Gail M. Kieckhefer, ARNP, PhD¹, April A. Greek, PhD², Jutta M. Joesch, PhD², Hyoshin H. Kim, PhD², and Nazli Baydar, PhD³. (1) Family & Child Nursing, University of Washington, Box 357262, Seattle, WA 98195, 206-543-8237, gailmk@u.washington.edu, (2) Battelle Centers for Public Health Research & Evaluation, 4500 Sand Point Way, NE, Seattle, WA 98105, (3) Psychology & Sociology, Koc University, Rumelifeneri Yolu, Istambul, Turkey

The AAP recommends each child have a medical home, a single provider of comprehensive, continuous, coordinated, and accessible healthcare. We examine the presence and quality of the medical home and use of asthma-related Emergency Department (ED) care and prescriptions among children with asthma. Data are from the 1996/98/99 Medical Expenditure Panel Survey (MEPS), a nationally representative in-person survey of the US population. The most knowledgeable adult providing care to children 0-17 years with asthma (n=1,311) noted the presence of a usual source of care (USC) in 93% of the cases. However, only 43% indicated a specific person or person-within-a-facility as the USC. A 9-item index of medical home qualities of the USC was composed of: would go to provider for new health problems, preventive care or referrals; ease of getting appointments; usual waiting time upon arrival; provider’s ability to listen/give information; confidence in provider’s ability to help; satisfaction with provider’s staff; overall quality of provider care. Persons ranking care lowest (0.5-7.5, 25%) were compared with those ranking care high (7.5-8.5, 39%) and highest (9.0, 36%). Chi-square was used to evaluate associations with ED and prescription use over a calendar year. Having a USC or specific person identified as the USC were not related to ED use, although both were associated with filling at least one asthma-related prescription, indicating first-line treatment availability. The index of other medical home qualities was also not related to ED or prescription use, but was higher when a specific person was identified as the USC.

Learning Objectives:

• At the conclusion of the session the participant (learner) will be able to:
• 1. List key components of a Medical Home.
• 2. Evaluate the presence and quality of a Medical Home for children with asthma.
• 3. Discuss the association between Medical Home and the use of asthma-related Emergency Department care and filling of at least one prescription, indicating first-line treatment availability.

Keywords: Medical Care, Access to Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.