A new study published last week in the journal Pediatrics showed that children without special healthcare needs who received care in a medical home model had fewer visits to their physicians, had lower rates of emergency room use and exhibited healthier behaviors than those in other care models.
The study, authored and led by Webb E. Long, MD, of the Boston University School of Medicine/Boston Medical Center, found that 21 out of every 100 kids without a medical home had been to the ED, compared with 16 out of every 100 children with a medical home.
The study was conducted in response to the recommendations within the Patient Protection and Affordable Care Act, which encourages the use of medical homes for pediatric care. While promoted by PPACA, the researchers noted there is not a significant body of research to show whether the model is an effective method of providing care for children without special healthcare needs.
"This study provides evidence that the medical home is associated with beneficial healthcare utilization, child health and health-promoting behavior outcomes in children without special healthcare needs," the study noted. "Our findings strengthen the evidence base for the (American Academy of Pediatricians') recommendation that all children have a medical home."
The researchers used survey data on the health of more than 70,000 children, of which 40,000 were receiving care in a medical home model. In addition to examining healthcare service utilization alone, the researchers drilled down to see whether participation in a medical home also led to healthier behaviors in the children.
"Our study broadened the outcomes measures assessed. Previous studies have focused on clinical outcomes such as ED utilization and immunizations," the authors wrote. "The medical home concept, however, is explicitly designed to provide care for all aspects of a child's health and well-being. We therefore selected health-promoting behavior outcomes previously demonstrated to be positively associated with child health."
Based on their study the researchers noted that children in a medical home did show a strong correlation to health-promoting behaviors including family reading, sleep, hygiene, helmet use and decreased screen time.
"Although the effects are modest, the near-universal reach of healthcare for children suggests that there may be a significant public health impact," the authors concluded. "We believe that future studies examining the impact of the medical home should consider reporting similar health-promoting behaviors."
While the study authors also advocate medical homes for all children without special healthcare needs – a population that comprises more than 80 percent of children – it did note some barriers inherent in the current healthcare system.
Most notable is the uneven access to a medical home. The report noted that non-white children were less likely to have access to a medical home and that further disparities exist based on parental income levels and education.