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Acad Pediatr. 2011 Nov-Dec;11(6):500-7. doi: 10.1016/j.acap.2011.08.010. Epub 2011 Oct 2.

The patient-centered medical home, practice patterns, and functional outcomes for children with attention deficit/hyperactivity disorder.

Author information

  • 1Division of General Pediatrics, Children's Hospital Boston, 300 Longwood Avenue, Boston, Massachusetts 02115, USA. sara.toomey@childrens.harvard.edu

Abstract

OBJECTIVE:

To determine whether children with attention deficit/hyperactivity disorder (ADHD) receive care in a patient-centered medical home (PCMH) and how that relates to their ADHD treatment and functional outcomes.

METHODS:

Cross-sectional analysis of the 2007 National Survey for Children's Health, a nationally representative survey of 91,642 parents. This analysis covers 5169 children with parent-reported ADHD ages 6-17. The independent variable is receiving care in a PCMH. Main outcome measures are receiving ADHD medication, mental health specialist involvement, and functional outcomes (difficulties with participation in activities, attending school, making friends; having problem behaviors; missed school days; and number of times parents contacted by school).

RESULTS:

Only 44% of children with ADHD received care in a PCMH. Children with ADHD receiving care in a PCMH compared with those who did not were more likely to receive medication for ADHD (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.1-1.9); less likely to have mental health specialist involvement (OR, 0.6; 95% CI, 0.4-0.7); less likely to have difficulties participating in activities (OR, 0.6; 95% CI 0.4-0.8), making friends (OR, 0.6; 95% CI, 0.5-0.9), and attending school (OR, 0.4; 95% CI, 0.3-06); less likely to have problem behaviors (OR 0.6; 95% CI 0.5-0.9); had fewer missed school days (β = -1.5, 95% CI -2.4 to -0.5); and parents were contacted by school less frequently (β = -0.2, 95% CI -0.3 to -0.1).

CONCLUSIONS:

For children with ADHD, receiving care in a PCMH is associated with practice pattern change and better outcomes. The PCMH may represent a promising opportunity to improve quality of care and outcomes for children with ADHD.

Copyright © 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

PMID:
21967721
[PubMed - indexed for MEDLINE]
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