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General Medical
Home Info
What is a Medical Home?
A medical home addresses how a primary health care
professional works in partnership with the family/patient
to assure that all of the medical and non-medical needs
of the patient are met. A medical home is defined as primary
care that is accessible, continuous, comprehensive, family
centered, coordinated, compassionate, and
culturally
effective. 1
A medical home includes:
- A partnership between the family and the
child's/youth's primary health care professional
- Relationships based on mutual trust and
respect
- Connections to supports and services to
meet the non-medical and medical needs of the child/youth
and their family
- Respect for a family's cultural and religious
beliefs
- After hours and weekend access to medical
consultation
- Families who feel supported in caring for
their child
- Primary health care professionals
coordinating care with a team of other care providers
Through this partnership, the primary health care professional
can help the family/patient access and coordinate specialty
care, educational services, in and out of home care, family
support, and other public and private community services
that are important to the overall health of the child/youth
and family. A medical home is not a building, house, or
hospital, but rather an approach to providing comprehensive
primary care.
Why Now?
- The need for an ongoing source of
health care— ideally a medical home—for all
children has been identified as a priority for child health
policy reform at the national and local level.
- The US Department of Health and Human
Services’ Healthy People 2010 goals and objectives
state that “all CSHCN will receive regular ongoing
comprehensive care within a medical home” and multiple
federal programs require that all children have access
to an ongoing source of health care. 2
Why CSHCN?
- Approximately 12.8 percent of children/youth in the
United States, or 9.4 million, have special health care
needs, based on the MCHB definition
- Approximately 1 out of 5 homes in
the United States has a child or youth with special health
care needs
Note: This does not include children and youth
at risk for a chronic condition.
3
CYSHCN: Financial Reality
- CYSHCN account for 80% of
pediatric health care expenditures
- Annual Cost of Medical Care
for CYSHCN
61% Hospitalizations
15% Other
(Therapies, Pharmaceuticals, Outpatient Lab, ED, Disposables)
14% Specialists
5% Primary Care
5% Durable Medical Equipment
-Health Partners/Institute for Health and Disability 2/97
Benefits of Coordinated Care in a Medical Home
- Increased patient and family satisfaction
- Establishment of a forum for problem solving
- Improved coordination of care
- Enhanced efficiency for children, youth, and families
- Efficient use of limited resources·
- Increased professional satisfaction
- Increased wellness resulting from comprehensive care
Cost/Quality Benefits
- Reduced hospitalizations
- Reduced length of Stay in hospital
- Reduced ED Utilization
- Increased Family and Provider Satisfaction1
Web sites
AAP National Center
of Medical Home Initiatives for CSHCN: www.medicalhomeinfo.org
The medical home Web site contains resources, information,
and tools on providing medical homes for children and youth
with special health care needs (CYSHCN). Visit this site
to learn more about CYSHCN, the providers and families that
care for them, and the strategies that practices, communities,
and states are taking to improve the lives of CYSHCN.
Center for Medical Home Improvement: www.medicalhomeimprovement.org
The mission of the Center for Medical Home Improvement
is to establish and support networks of parent/professional
teams to improve the quality of primary care medical homes
for children and youth with special health care needs and
their families. Useful tools, assessments, and resources
are available on this site.
MedHome Portal:
www.medhomeportal.org
The MedHome Portal is a web-based
resource aimed at providing primary care physicians with
ready access to information, tools, and services to improve
their care and coordination of care for their patients with
special needs
Oregon Medical Home Web site: cdrc.ohsu.edu/oscshn1/medicalhome/
This site contains general information about the medical
home and educational materials and resources to support
families of CSHCN, health care providers and other community
professionals such as teachers and early intervention professionals.
Their primary purpose is to make these supports available
to the pediatric practices and medical home resource teams
who are partners in the Oregon Medical Home Project.
Primer on the Illinois Medical Home Model for Physicians:
internet.dscc.uic.edu/medhome/mdprimer/MHPhysicianPrimer.asp
The first two components of the Illinois Medical Home Model
define what it means when families say they have a Medical
Home and what it means when physicians say they provide
a Medical Home. The third component describes the activities
occurring in Illinois to promote the Medical Home Model.
The primer includes references, video clips, PowerPoint
presentations and many handouts that are downloadable. Also
included is the 2nd edition of the UIC-DSCC Medical Home
CME Monograph for community pediatricians and family physicians
that was published on May 1, 2004. The entire 70 page document
is downloadable as a PDF file.
Primer on the Illinois Medical Home Model for Families:
internet.dscc.uic.edu/medhome/familyprimer/FamilyMHPrimer.asp
" What Families Need to Know about a Medical Home"
has been developed to explain the Medical Home Model for
families and children with special health care needs. It
explains the family-professional partnership and how it
relates to accessing quality health care. The primer goes
on to explain how families can become proactively involved
in Quality Improvement Teams in their primary care provider's
practice. There are links to the AAP web site describing
what others states are doing to promote Medical Home, a
downloadable Parent-Partner Guide, Power Point presentations,
and information about the Illinois Title V CSHCN Program
Special Needs Resource Directory
of Southwest Ohio: www.cincinnatichildrens.org/svc/alpha/c/special-needs/resources/default.htm
The Center for Infants and Children with Special Needs
at Cincinnati Children's Hospital Medical Center has created
an extensive, one-stop resource directory to assist caregivers
of children with specialized health care needs. The goal
of the Special Needs Resource Directory is to provide comprehensive
web-based information -- assembled in one convenient location
-- to both parents and professionals.
The directory includes information on issues related to
advocacy, assistive technology, clinical trials, community
services, dental care, education, employment, estate and
future planning, financial assistance, guardianship, home
health care, mental health, MR/DD services, nutrition resources,
summer programming, therapies, transition issues, transportation,
and wish-granting organizations.
TelAbility: www.telability.org/index.pl
An innovative, community oriented, interdisciplinary program
that uses telecommunications to improve the lives of children
with disabilities. Using real time video-conferencing and
internet technologies, TelAbility provides comprehensive,
coordinated, family centered care to children with disabilities
across North Carolina and offers education, training, and
peer support for people who care for them.
Washington State Medical Home
Web Site: www.medicalhome.org/
Use this website to find successful strategies and practical
medical home tools developed for busy families and professionals.
- Families: Find strategies and tips to develop a partnership
with your child's physician, organize your paperwork,
advocate for your child, take care of yourself, and other
tips from parents who've "been there".
- Physicians: Find diagnosis-specific care guidelines,
patient education materials, printable lists of community
services by county for children with special needs, reimbursement
options, coding tips and office management strategies.
- Other Medical Home Partners: Find referral forms and
strategies to improve communication with primary care
physicians, tips on how to empower families to become
more effective medical home partners and advocates for
their children and more.
- Links to other community, state and national resources
and services
1. American Academy
of Pediatrics The
Medical Home. Supplement to Pediatrics. Pediatrics.
2004:113(suppl):1471-1548
2. Medical Home Initiatives for Children
With Special Needs Project Advisory Committee. Policy Statement:
Organizational
Principles to Guide and Define the Child Health Care System
and/or Improve the Health of All Children. Pediatrics.
2004;113(suppl):1545-1547
3. MCHB/NCHS. National
Survey of Children with Special Health Care Needs. 2002
Last Updated
March 8, 2007
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