Three-Year NH-Based Study Finds Pediatric Medical Homes Significantly Increase Level of Children's Health Care

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Parents reported fewer hospitalizations, fewer absent schools days, less worry about their child's health when their child's care was coordinated through a medical home.

The primary care medical home occupies a central role in healthcare reform

The latest issue of the Journal of Ambulatory Care Management features a report on a three-year survey of the effectiveness of using medical homes as a coordination point for pediatric health care. Ten pilot practices in Vermont and New Hampshire were used in the survey.

A "medical home" is a community-based primary care setting that provides and coordinates high quality, planned, family-centered health promotion, acute illness care and chronic condition management.

Parents who were surveyed reported fewer hospitalizations, fewer absent schools days, less worry about their child's health, and increased likelihood of having a written health care plan when their child's care was coordinated through a medical home.

"A low percentage of all children have such complex needs that care involves multiple community agencies and health-care providers, but this population does account for over half of national expenses on pediatric healthcare," said Jeanne McAllister, RN, MS, MHA, co-author of the report and director of the Center for Medical Home Improvement at the Crotched Mountain Foundation in Greenfield, NH. "Children's health care often lacks a centralizing coordination point for teams of agencies and doctors, causing the care to become fragmented or overly specialized."

The Center for Medical Home Improvement (CMHI) is a New Hampshire-based organization committed to improving community-based health care systems for children with special health care needs and their families.

The US Maternal and Child Health Bureau funded eight medical home projects between 2001 and 2004, one of which was awarded to New Hampshire's Center for Medical Home Improvement. CMHI recruited 10 primary care practices (rural, suburban, and urban) in New Hampshire and Vermont to participate in the implementation of a series of medical home improvements. Parents and caregivers became equal and critical partners, and core teams of physicians, care coordinators, and parents met regularly to improve healthcare delivery. Over 300 families were asked to complete a survey about the process each year.

"The primary care medical home occupies a central role in healthcare reform," said W. Carl Cooley, M.D., co-author of the report and Medical Director of the Center for Medical Home Improvement. "Healthcare teams in medical homes work to know the children and families in their home to help facilitate all aspects of care in a culturally effective partnership."

The article was authored by Jeanne McAllister, BSN, MS, MHA, Kathleen Sherrieb, MS, DrPH and W. Carl Cooley, M.D.

About CMHI
A medical home is community-based primary care practice that coordinates high quality, family-centered health, acute illness care and chronic condition management. Coordinating health care pays enormous dividends. The mission of CMHI (the Center for Medical Home Improvement), a project of the Crotched Mountain Foundation, is to advance the medical home model and secure health policy changes crucial to the future of primary care.

CMHI currently works in partnership with the Special Medical Services division of NHDHHS, the NH Citizen's Health Initiative, Dartmouth Medical School, the Institute on Disability at UNH, and consults nationally on various medical home-related initiatives. For more information: http://www.medicalhomeimprovement.org.

About the Crotched Mountain Foundation
Crotched Mountain is a charitable organization whose mission is to serve individuals with disabilities and their families, embracing personal choice and development, and building communities of mutual support. Crotched Mountain provides specialized education, rehabilitation, community, and residential support services for more than 2,000 individuals living in New England and New York. For more information about the Crotched Mountain Foundation, please visit http://www.crotchedmountain.org.

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