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Medical Homes: The Wave of the Future

It is difficult to provide children with quality and comprehensive care. Adding to the difficulties is the fact that health care providers do not typically share information about patients they have in common. This lack of coordination can lead to wasted resources, diminished quality of care, and duplicated efforts.

Primary care providers are becoming increasingly scarce as more doctors opt for the better-paying specialist jobs. Those patients who are able to find a primary care provider who fits their needs may have problems making appointments, since the need for these providers are usually pretty high.

The medical home seeks to fix problems with the health care system in the United States by bringing care back to a centralized system.

What Are Medical Homes?

Medical homes, also known as patient-centered medical homes, are community-based, family-centered care centers that provide continued care from birth through adolescence and subsequently help youth transition into adult services. The medical home model was developed by the American Academy of Pediatrics to help deliver primary care that is compassionate, culturally competent, and accessible to all children.

Medical homes are an approach created to facilitate collaborative and comprehensive working relationships with patients, their families, and clinicians. It is especially helpful in caring for children and youth with special health care needs.

How Do Medical Homes Work?

Medical homes are organizational settings that integrate management of acute illnesses and chronic conditions as well as provide preventive services. To be effective, medical homes must include the following:

  • Care that is patient-centered: Medical homes seek to anticipate care needs for children and families at any given point in time.
  • Patient education: To best achieve positive results, medical homes seek to nurture competence in families and patients.
  • Coordination of care: Medical homes seek to coordinate with organizations and agencies in the child’s community and within the health care system to address the patient’s health needs.
  • Continuity of care: Medical homes provide continued care to children throughout their childhood and help with the transition to adult services.

Evidence of Medical Homes’ Effectiveness

A number of peer-reviewed studies examining the effectiveness of medical homes have been published. They almost universally show that medical homes are indeed effective in improving health care to children.

The Centers for Disease Control and Prevention did a study in 2007. They interviewed 5400 parents. Based on their research, the authors of the study found medical homes were responsible for higher rates of vaccinations.

A 2010 study by Reid et al. in Seattle found medical homes were responsible for six percent fewer hospitalizations and 29 percent fewer emergency room visits. The study also found medical homes contributed to a total savings of $10.30 per patient per month over the course of the study.

In 2007, Schoen et al. associated medical homes with a laundry list of health gains. Some of these include fewer duplicate tests, improvements in the flow of information between providers, ease of accessing after hours care, fewer medical errors, and improved opinions of health care in general.

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Any discussion of medical homes should address the little yet still present controversy associated with the system. Some critics argue the medical homes system is similar to the “gatekeeper” model used by health maintenance organizations (HMOs). The gatekeeper model essentially only allows patients to go to specific providers. If they want to see other providers, they must get a referral.

Medical homes differ from HMOs in that they allow patients to access any providers without a referral. The patient has a primary provider who facilitates the spread of information to subspecialists.

Medical homes are a growing trend in providing comprehensive care to children. They provide a great “one-stop shopping” resource to families and ensure that all of a child’s health care providers are on the same page.

(http://cfm.mc.duke.edu/modules/cfm_medhomes/index.php?id=1)

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