A number of the characteristics
of high-quality health care for children can be combined into the
concept of the medical home. As defined by the American Academy of
Pediatrics, children’s medical care should be accessible, family-centered,
continuous, comprehensive, coordinated, compassionate, and culturally
effective.1 The NSCH included several
questions that sought to measure whether a child’s health care met
this standard:
- Whether the child has at least one personal doctor or nurse
who knows him or her well;
- Whether this personal doctor or nurse usually or always spends
enough time with the family, explains things so the parent can
understand, and provides interpreter services when needed;
- Whether this personal doctor or nurse usually or always provides
telephone advice or urgent care when the child needs it;
- Whether the child has little or no problem gaining access to
specialty care, services, and/or equipment when it is needed;
- Whether the personal doctor or nurse followed up by talking
with the family about the child’s specialist visit and/or use
of special services or equipment; and
- Whether the child had a preventive visit in the past year. A
child was defined as having a medical home if he or she had at
least one preventive visit in the past year, had little or no
problem with access to specialty care, and reported having a personal
doctor or nurse who usually or always spent enough time and communicated
clearly with families, provided telephone advice or urgent care
when needed, and followed up with the family after the child’s
specialty care visits.
Overall, 46.1 percent of children
receive care that meets this standard.
Children living in urban areas are
slightly more likely to have a medical
home than children in other locations:
the urban rate is 46.4 percent, compared
to 44.7 percent in large rural
and 45.2 percent in small rural areas.
1 American Academy of Pediatrics, Medical Home
Initiatives for Children with Special Needs Project
Advisory Committee. The medical home. Pediatrics
2002;110(1):184-86.
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