Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #105496

Savithri Nageswaran, MD, MPH, Department of Pediatrics, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, (336) 716 6508, snageswa@wfubmc.edu and Anita M. Farel, DrPH, Maternal and Child Health, School of Public Health, 426 Rosenau Hall, CB# 7445, University of North Carolina, Chapel Hill, NC 27599-7545.

Background: North Carolina uses the medical home as a model for providing comprehensive care to children with special health care needs (CSHCN). However, until recently, population-based data for evaluating the impact of this model was not available at the state level. NC data, generated by the National Survey of Children with Special Health Care Needs (2000-2002), made it possible to assess access to a medical home among the state's CSHCN.

Methods: Bivariate analysis of socio-demographic factors with medical home and its 5 components (family-centered care, effective care coordination, personal doctor or nurse, usual care source, referral problems) was conducted. The impact of having a medical home on the outcomes of CSHCN and their families was analyzed. Multivariate analysis was conducted to identify the predictors of having a medical home.

Results: Fifty six percent of CSHCN in North Carolina have a medical home. White CSHCN have 1.7 times the odds of having a medical home compared to non-White CSHCN. CSHCN with no limitation of activities due to their condition have 1.6 times the odds of having a medical home compared to those who have limitation of activities. Access to a medical home mitigates the impact of special health care needs on children and their families.

Conclusions: Results from the National Survey of Children with Special Health Care Needs are useful for illuminating features of the medical home that state programs must implement to meet the needs of CSHCN and their families and to monitor progress in meeting Healthy People 2010 goals.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Define the medical home concept in organizing care for children with special health care needs.
• Recognize the disparities among children with special health care needs in having access to a medical home

Keywords: Children With Special Needs,

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.