Components of the Medical Home
One important aspect of the medical home is whether or not children receive care that is “family-centered;” that is, whether parents report that their children's doctors usually or always spend enough time with the family, listen carefully to their concerns, are sensitive to their values and customs, provide needed information, make the family feel like a partner in their child's care, and provide an interpreter when needed. Together, these measures of family-centered care provide an important picture of how comfortable families feel with their children's medical care. Whether or not they have special health care needs, approximately two-thirds of children are reported to receive family-centered care. However, when one takes into account other differences between CSHCN and non-CSHCN (such as income, insurance status, and race), CSHCN are slightly less likely (65.5 percent) to receive family-centered care than non-CSHCN (67.8 percent).
CSHCN with more complex service needs are less likely to receive family-centered care: 60.5 percent receive care that meets this standard. Of all racial and ethnic groups, Black and Hispanic CSHCN are the least likely to receive family-centered care. Of Hispanic CSHCN in Spanish-speaking households, only 33.2 percent receive family-centered care.
CSHCN with emotional, behavioral, or developmental problems are less likely than CSHCN without these problems to receive family-centered care. Of CSHCN with these problems, 54.2 percent received family-centered care, compared to 70.9 percent of CSHCN who do not have emotional, behavioral, or developmental problems.
Also important to the concept of the medical home is children's access to primary and preventive care, consistent care when they are sick, and support for care coordination. Overall, more than 90 percent of children receive care that meets these standards; however, CSHCN are slightly more likely than children without special health care needs to have a personal doctor or nurse and a regular source of care when they are sick. In contrast, CSHCN are considerably less likely than other children to receive effective care coordination services: only 59.3 percent of CSHCN who used two or more health care services received coordinated care, compared to 73.6 percent of children without special health care needs. Of CSHCN with emotional, behavioral, or developmental problems, 48.0 percent received effective care coordination, compared to 66.3 percent of CSHCN who do not have these problems. Uninsured CSHCN are considerably less likely than those with either public or private insurance to have a personal doctor or nurse, have a regular source of sick care, or to receive coordinated care.