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Matern Child Health J. 2018 Oct;22(10):1451-1461. doi: 10.1007/s10995-018-2540-z.

Patient-Centered Medical Home and Receipt of Part C Early Intervention Among Young CSHCN and Developmental Disabilities Versus Delays: NS-CSHCN 2009-2010.

Author information

1
Kinesiology, Adapted Physical Activity, College of Public Health and Human Sciences, Oregon State University, Women's Building 08b 160 SW 26th Street, Corvallis, OR, 97331, USA. Samantha.Ross@oregonstate.edu.
2
Public Health, Epidemiology School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Milam 135, Corvallis, OR, 97331, USA.
3
School of Kinesiology, School of Public Health, Epidemiology, University of Michigan, 1402 Washington Heights, Ann Arbor, MI, 48109-2013, USA.
4
Kinesiology, Adapted Physical Activity, College of Public Health and Human Sciences, Oregon State University, Women's Building 203B, Corvallis, OR, 97331, USA.
5
Children's Outcomes Research Group, Department of Health Systems, Management and Policy, Colorado School of Public Health, 13001 E. 17th Place, MS B119, Aurora, CO, 80045, USA.

Abstract

Objective To determine, among a sample of young CSHCN with developmental conditions, (1) characteristics associated with receipt of both patient-centered medical home (PCMH) and Part C early intervention, (2) the association between each PCMH criterion and receipt of Part C generally, and (3) for CSHCN with disabilities versus delays. Methods Secondary data analysis of the 2009/10 National Survey of CSHCN. Sample included CSHCN (n = 755) birth to 3 years with a developmental disability or delay that affected their function. Adjusted ordinal regression analysis examined characteristics associated with receiving both PCMH and Part C. Stratified adjusted logistic regression examined the association between PCMH criteria and Part C, by disabilities versus delays. Results 19% of our sample received both PCMH and Part C. Black, non-Hispanic children had lower odds [OR 0.44, 95% CI (0.20, 0.97)] and CSHCN with more severe developmental conditions had higher odds [OR 2.13, 95% CI (1.22, 3.17)] of receiving both services. CSHCN with a PCMH were no more likely to be receiving Part C than those without a PCMH [OR 0.85, 95% CI (0.49, 1.49)]. Receiving any one of the PCMH criterion was not associated with receiving Part C, with one exception. Among CSHCN with delays, effective care coordination was associated with lower odds of Part C [OR 0.46, 95% CI (0.21, 0.97)]. Conclusion Concurrent PCMH and Part C access was low for young CSHCN with developmental conditions affecting their function. Given the overlapping mandates for PCMH and Part C, integrated efforts are warranted to identify if lack of concurrent services in fact reflects unmet service needs.

KEYWORDS:

Children with special health care needs; Developmental screening; Early intervention; Health care utilization; Patient-centered medical home; Service access

PMID:
29869730
DOI:
10.1007/s10995-018-2540-z
[Indexed for MEDLINE]

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