Megan E. Sety, MSW, Center for Children with Special Needs, Children's Hospital and Regional Medical Center, PO Box 50020, Mailstop: S-219, Seattle, WA 98145, (206) 987-5310, megan.sety@seattlechildrens.org, James M Krieger, MD MPH, Public Health-Seattle & King County and University of Washington Schools of Public health and Medicine, 999 Third Ave., Suite 1200, Seattle, WA 98104, Michelle Bell, MSW, PhD, School of Public Health & Community Medicine, Maternal and Child Health Program (MCH), University of Washington, Box 357230, Seattle, WA 98195-7230, and Gail M. Kieckhefer, ARNP, PhD, Family & Child Nursing, University of Washington, Box 357262, Seattle, WA 98195.

Both Healthy People 2010 and core performance measures for Title V Maternal and Child Health Programs state that every child with special health care needs must receive coordinated, ongoing, comprehensive care within a medical home. The purpose of this study was to examine the impact of the medical home service delivery model on measurable disease management outcomes in chronic childhood asthma (n=143). This study piloted an expanded measure of medical home assessing the core components as identified by the National Center of Medical Home Initiatives for Children with Special Needs: accessible, family-centered, continuous, comprehensive, coordinated, compassionate and culturally-effective. Disease management was assessed through parent self-efficacy, parent self-regulation, unplanned clinic visits, and emergency room visits. Medical home was not significantly correlated with ER visits (OR = 1.002, p = 0.940, CI = .963, 1.041) or unplanned clinic visits (OR = 1.012, p = 0.362, CI = .986, 1.040). Medical home was significantly correlated with parent self-efficacy (coefficient = 0.008, R² = 0.070, p=0.002) and parent self-regulation (coefficient = 0.006, R² = 0.040, p=0.017). These relationships persisted after adjusting for race, disease severity, caregiver quality of life and type of insurance. Medical home contributes to the disease management process, affecting endpoint emergent health care utilization for children with chronic conditions.

Learning Objectives:

• Compare methods to measure medical home in a pediatric population
• Evaluate the presence of medical home using an expanded measure
• Discuss the relationship between medical home provision and parental self-efficacy/self-regulation as they relate to end-point health care utilization

Keywords: Special Needs, Outcome Measures

Related Web page: www.cshcn.org

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.