Effects of a Medical Home Program for Children with Special Health Care Needs on Parental Perceptions of Care in an Ethnically Diverse Patient Population

The Pediatric Medical Home Program at UCLA enrolled 41 patients in a primary care model focused on providing intensive care
coordination for medically complex, ethnically diverse children with special health care needs (CSHCN) in our Pediatric Resident
Continuity clinic. We sought to determine the effect of our program on parental satisfaction, and to compare differences in
parental satisfaction between English and Spanish speaking patients. The Medical Home Family Index, developed by the Center
for Medical Home Improvement, was administered to a total of 22 participating parents, in the family’s primary language by
a native speaker, at various times after enrollment in the program. Survey data and language effects were analyzed. The 36
standardized mean scores for the 15 Spanish speaking families were significantly higher (8.5 points higher) than the mean
scores from the seven English speaking families (p = 0.003). Although no statistically significant differences were noted in individual questions between Spanish and English
speakers, a trend towards more positive responses by Spanish speakers was noted in questions regarding physician-patient communication
(p = 0.054) and family-centeredness (p = 0.053). Our results suggest that a primary care model focused on providing intensive care coordination produces positive
parental perceptions of the organization and delivery of primary care services in a medically complex population of CSHCN.
The main finding of the study is that utilizing the AAP’s approach to the medical home model, emphasizing family-centered
and culturally competent care, can produce higher satisfaction scores in Spanish speaking parents when compared to English
speaking parents.