The use of the patient-centered medical home for children with medical complexity

Abstract

Children with medical complexity (CMC) comprise a small amount of total pediatric patients but contribute to a large portion of total pediatric spending and health care utilization. As a result, there is great interest in creating innovations in their health care delivery systems to improve their quality of care and contain costs. One unique aspect of the health care of CMC is its fragmented nature. Since CMC commonly have multiple co-morbidities, they often receive care from several different specialists at any given time. The patient-centered medical home (PCMH) was previously suggested as a possible tool to improve the fragmented care of CMC. Although definitions of the medical home vary, common themes are its function to better coordinate and integrate the care of patients. Current studies suggest that many CMC do not make regular primary care visits or receive care that fulfills a majority of the components of a medical home. In addition, according to the limited studies that exist which examine CMC and other children with special health care needs (CSHCN), primary care and medical home usage amongst these populations may reduce the occurrence of preventable medical events like hospital readmissions or emergency department visits. Therefore, further research and work should be conducted to examine the feasibility and actions that must be conducted in order to increase the prevalence of these medical home programs amongst CMC.