Indicator: Percent of Children With a Medical Home

Priority or Priorities: Early Childhood Development, ACES/Resiliency
Initiative(s): Promote and Support Universal Home Visiting Services 7, 8, 10
Outcome (s): Families recognizing the rewards and responsibilities of raising children, Families living safe and healthy lives, Communities creating colloborative partnerships

Why This is Important

The need for an ongoing source of health care—ideally a medical home—for all children has been identified as a priority for child health policy reform at the national and local level. The US Department of Health and Human Services’ Healthy People 2010 goals and objectives state that "all children with special health care needs will receive regular ongoing comprehensive care within a medical home" 1 and multiple federal programs require that all children have access to an ongoing source of health care. In contrast to care provided in a medical home, care provided through emergency departments, walk-in clinics, and other urgent-care facilities, though sometimes necessary, is more costly and often less effective.2

Where We Stand

Nationally, 46.1% of children (whose parents responded to the survey) have a medical home. While Maine exceeds the national statistic, it has the lowest percent of children with a medical home among the New England states.

Data Source and Context

The source of this data is the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. The National Survey of Children's Health 2003: U.S. Department of Health and Human Services, 2005.

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. 3

The survey 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.

1 US Department of Health and Human Services, Health Resources and Services Administration. Measuring Success for Healthy People 2010: National Agenda for Children with Special Health Care Needs. Washington, DC: US Department of Health and Human Services;
1999. http://mchb.hrsa.gov/programs/specialneeds/measuresuccess.htm.

2 American Academy of Pediatrics, Medical Home Initiatives for Children with Special Needs Project Advisory Committee. The medical home. Pediatrics 2002;110(1):184-186.

3 American Academy of Pediatrics, Medical Home Initiatives for Children with Special Needs Project Advisory Committee. The medical home. Pediatrics 2002;110(1):184-186.