Abstract
Providing a medical home to children with Attention-Deficit Hyperactivity Disorder (ADHD) is challenging. Little is known
about the factors associated with having a medical home for these children, or how comorbidities affect having a medical home.
Our study aims are: (1) identify factors associated with having a medical home and five sub-components of a medical home and
(2) determine the effect of medical home on several outcomes for children with ADHD. The sample included 5,495 children with
ADHD from the 2007 National Survey of Children’s Health. Descriptive and multivariate analyses were conducted. Children with
ADHD alone and children with ADHD plus a physical diagnosis had greater frequencies of having a medical home, or meeting the
five sub-components, than children with ADHD plus a mental diagnosis. Multivariate results show that children with ADHD plus
a physical and/or mental comorbidity were 24–63% more likely to be without a medical home compared to children with only ADHD.
Having a medical home also had a bearing on several child health outcomes. Having a medical home was significantly associated
with being less likely to have an unmet health need and having fewer missed school days; but also being less likely to have
received needed mental health care (P < .05). Our results suggest that there are differences in parent’s perceptions of receiving care among children with ADHD. Pediatric
medical home projects and policies should acknowledge that children with ADHD often have comorbidities making their care more
complex. These complexities should be addressed during practice transformation and setting reimbursement policies.
about the factors associated with having a medical home for these children, or how comorbidities affect having a medical home.
Our study aims are: (1) identify factors associated with having a medical home and five sub-components of a medical home and
(2) determine the effect of medical home on several outcomes for children with ADHD. The sample included 5,495 children with
ADHD from the 2007 National Survey of Children’s Health. Descriptive and multivariate analyses were conducted. Children with
ADHD alone and children with ADHD plus a physical diagnosis had greater frequencies of having a medical home, or meeting the
five sub-components, than children with ADHD plus a mental diagnosis. Multivariate results show that children with ADHD plus
a physical and/or mental comorbidity were 24–63% more likely to be without a medical home compared to children with only ADHD.
Having a medical home also had a bearing on several child health outcomes. Having a medical home was significantly associated
with being less likely to have an unmet health need and having fewer missed school days; but also being less likely to have
received needed mental health care (P < .05). Our results suggest that there are differences in parent’s perceptions of receiving care among children with ADHD. Pediatric
medical home projects and policies should acknowledge that children with ADHD often have comorbidities making their care more
complex. These complexities should be addressed during practice transformation and setting reimbursement policies.
- Content Type Journal Article
- Pages 1-8
- DOI 10.1007/s10995-011-0922-6
- Authors
- Caprice A. Knapp, Department of Health Outcomes and Policy, University of Florida, 1329 SW 16th Street, Room 5130, Gainesville, FL 32610, USA
- Melanie Hinojosa, Department of Health Outcomes and Policy, University of Florida, 1329 SW 16th Street, Room 5130, Gainesville, FL 32610, USA
- Jacqueline Baron-Lee, Department of Health Outcomes and Policy, University of Florida, 1329 SW 16th Street, Room 5130, Gainesville, FL 32610, USA
- Dan Fernandez-Baca, Department of Health Outcomes and Policy, University of Florida, 1329 SW 16th Street, Room 5130, Gainesville, FL 32610, USA
- Ramon Hinojosa, Rehabilitation Outcomes Research Center, North Florida/South Georgia Veterans Health System, Gainesville, FL 32610, USA
- Lindsay Thompson, Department of Pediatrics, University of Florida, Gainesville, FL 32610, USA
- Journal Maternal and Child Health Journal
- Online ISSN 1573-6628
- Print ISSN 1092-7875