177873 Does access to a medical home reduce the family impact of autism spectrum disorder? A national study of children with special health care needs, 2005-2006

Tuesday, October 28, 2008: 8:40 AM

Michael D. Kogan, PhD , Office of Epidemiology, Policy and Evaluation, HRSA/ Maternal and Child Health Bureau, Rockville, MD
Bonnie B. Strickland, PhD , Maternal and Child Health Bureau/Division of Services for Children with Special Health Care Needs, Health Resources and Services Administration, Rockville, MD
Stephen J. Blumberg, PhD , National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD
Gopal K. Singh, PhD , Office of Data and Program Development, HRSA/Maternal and Child Health Bureau, Rockville, MD
James M. Perrin, MD , Division of Pediatrics, Harvard Medical School, Boston, MA
Peter C. Van Dyck, MD, MPH , Maternal and Child Health Bureau, HRSA, Rockville, MD
The medical home has emerged as a model of comprehensive, coordinated, family-centered health care for children. Having a medical home has been associated with reduced unmet health care needs and improved subspecialty care. However, whether having a medical home is associated with less family impact from having a child with a complex condition such as autism spectrum disorder (ASD) has not been examined. Children with ASD often have multiple concurrent disorders requiring a broad range of services. We used the 2005-2006 National Survey of Children with Special Health Care Needs (CSHCN) to compare 2,088 CSHCN, ages 3-17, reported to have ASD with other CSHCN on five measures of family impact related to the child's health care (financial problems; needing additional income; reducing/stopping work; spending 10+ hours per week on care; and paying > $1000 for medical care). Using logistic regression, we examined each family impact measure in relation to the joint association between ASD and presence of a medical home, after adjusting for sociodemographic factors, insurance type, and severity of child's health condition. Relative to CSHCN without ASD, CSHCN with ASD were less likely to have a medical home (48% vs. 26.5%). CSCHN with ASD and no medical home had significantly greater family impact compared to CSHCN with ASD who had a medical home. Moreover, the impact of ASD (i.e., the difference between CSHCN with ASD and CSHCN without ASD) is smaller when CSHCN have a medical home. Medical homes appear to have the potential to improve the lives of families of children with ASD.

Learning Objectives:
1. Describe the various components of a medical home. 2. Discuss why it's important for children with autism spectrum disorder to have a medical home. 3. Articulate how having a medical home may lead to reduced family impacts.

Keywords: Children With Special Needs, Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I'm the study director and I've published on these topics before.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.