TY - JOUR KW - Adolescent KW - Child KW - Child Health Services/organization & administration KW - Child, Preschool KW - Comprehensive Health Care/organization & administration KW - Female KW - Humans KW - Infant KW - Male KW - Multivariate Analysis KW - Outcome Assessment (Health Care) KW - Patient Care Team KW - Patient Satisfaction KW - Pediatrics/organization & administration KW - Primary Health Care/organization & administration KW - United States KW - Young Adult AU - W. C. Cooley AU - J. W. McAllister AU - K. Sherrieb AU - K. Kuhlthau A1 - AB - OBJECTIVE: The medical home model with its emphasis on planned care, care coordination, family-centered approaches, and quality provides an attractive concept construct for primary care redesign. Studies of medical home components have shown increased quality and reduced costs, but the medical home model as a whole has not been studied systematically. This study tested the hypothesis that increased medical homeness in primary care practice is associated with decreased utilization of health services and increased patient satisfaction. METHODS: Forty-three primary care practices were identified through 7 health plans in 5 states. Using the Medical Home Index (MHI), each practice's implementation of medical home concepts "medical homeness" was measured. Health plans provided the previous year's utilization data for children with 6 chronic conditions. The plans identified 42 children in each practice with these chronic conditions and surveyed their families regarding satisfaction with care and burden of illness. RESULTS: Higher MHI scores and higher subdomain scores for organizational capacity, care coordination, and chronic-condition management were associated with significantly fewer hospitalizations. Higher chronic-condition management scores were associated with lower emergency department use. Family survey data yielded no recognizable trends with respect to the medical home measurement. CONCLUSIONS: Developing an evidence base for the value of the primary care medical home has importance for providers, payers, policy makers, and consumers. Reducing hospitalizations through enhanced primary care provides a potential case for new reimbursement strategies supporting medical home services such as care coordination. Larger-scale studies are needed to further develop/examine these relationships. BT - Pediatrics C5 - Healthcare Policy; Medical Home CP - 1 CY - United States DO - 10.1542/peds.2008-2600 IS - 1 JF - Pediatrics N2 - OBJECTIVE: The medical home model with its emphasis on planned care, care coordination, family-centered approaches, and quality provides an attractive concept construct for primary care redesign. Studies of medical home components have shown increased quality and reduced costs, but the medical home model as a whole has not been studied systematically. This study tested the hypothesis that increased medical homeness in primary care practice is associated with decreased utilization of health services and increased patient satisfaction. METHODS: Forty-three primary care practices were identified through 7 health plans in 5 states. Using the Medical Home Index (MHI), each practice's implementation of medical home concepts "medical homeness" was measured. Health plans provided the previous year's utilization data for children with 6 chronic conditions. The plans identified 42 children in each practice with these chronic conditions and surveyed their families regarding satisfaction with care and burden of illness. RESULTS: Higher MHI scores and higher subdomain scores for organizational capacity, care coordination, and chronic-condition management were associated with significantly fewer hospitalizations. Higher chronic-condition management scores were associated with lower emergency department use. Family survey data yielded no recognizable trends with respect to the medical home measurement. CONCLUSIONS: Developing an evidence base for the value of the primary care medical home has importance for providers, payers, policy makers, and consumers. Reducing hospitalizations through enhanced primary care provides a potential case for new reimbursement strategies supporting medical home services such as care coordination. Larger-scale studies are needed to further develop/examine these relationships. PP - United States PY - 2009 SN - 1098-4275; 0031-4005 SP - 358 EP - 364 EP - T1 - Improved outcomes associated with medical home implementation in pediatric primary care T2 - Pediatrics TI - Improved outcomes associated with medical home implementation in pediatric primary care U1 - Healthcare Policy; Medical Home U2 - 19564320 U3 - 10.1542/peds.2008-2600 VL - 124 VO - 1098-4275; 0031-4005 Y1 - 2009 ER -