Online Program

Importance of a medical home on access to care for children with autism spectrum disorders

Tuesday, November 5, 2013

Nancy Cheak-Zamora, PhD, Health Sciences, University of Missouri- Columbia, Columbia, MO
Janet Farmer, PhD, Health Psychology, University of Missouri, Columbia, MO
Mary Clark, RN, MPH, TE Atkins Wellness Program, University of Missouri, Columbia, MO
Children with autism spectrum disorders (ASD) experience more difficulty accessing primary and specialty health care services than children with other special health care needs. Increased need for specialty care and poor quality of care likely increase this disparity. This project sought to determine the relationship between having a medical home and children's unmet specialty care needs. This study used data on children with ASD within the 2009-2010 National Survey of Children with Special Health Care Needs (n=3,055). Descriptive statistics identified sample characteristics, access to a medical home and needed specialty care services. T-tests examined differences in unmet needs of children with and without a medical home. Multiple regression analysis examined whether having a medical home predicted the number of unmet service needs after controlling for demographic, family and condition-related characteristics. Less than a quarter of children with ASD (24%) had a medical home. While, nearly all children (98%) had at least one specialty care need, 36% had an unmet need within the year. Children with a medical home had fewer unmet needs (X=0.15, SD=.02) than those without a medical home ((X=0.69, SD=.04), t(2850) = 5.48, p>.000). The regression showed that family characteristics, number of needed services and the presence of a medical home were significant predictors of unmet needs. These findings reveal the importance of a medical home in contributing to access to needed services for children with ASD. Improving access to a medical home will likely improve receipt of needed services and quality of life and decrease family burden.

Learning Areas:

Basic medical science applied in public health
Provision of health care to the public
Public health administration or related administration
Public health or related organizational policy, standards, or other guidelines
Public health or related research

Learning Objectives:
Evaluate the level of access children with autism spectrum disorders (ASD) have to a primary care medical home. Identify the number of children with ASD with an unmet need for specialty health care services. Further define the type of unmet need and likelihood of multiple unmet needs. Assess what variables predict the number of unmet service needs for children with ASD.

Keyword(s): Children With Special Needs, Access to Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the prinicipal investigator on multiple funded grants focusing on children and youth with ASD and access to health care issue. I have worked with children and youth with ASD for over 10 years in both clinical and research settings. I have published previous work related to this topic in top academic peer-reviewed journals including Pediatrics.
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.