Children who have chronic, complicated medical issues receive more effective and less expensive care when they are treated at what is called a patient-centered medical home. They are more likely to become seriously ill and need hospitalization or emergency room care when they receive treatment from a medical home than if they use several unconnected doctors and specialists, according to a study.
A medical home is a clinic or group medical practice that has a team of dedicated healthcare professionals. The idea has been around for a long time, but has become more popular as healthcare reforms are put into place. In a medical home, each person has a primary care physician who coordinates their care with specialists and other healthcare professionals.
The study evaluated an enhanced medical home, where 105 children with severe chronic illnesses received intense coordinated care through the High-Risk Children's Clinic at the University of Texas, Houston. Another 96 similar children received regular care from doctors or clinics. Many of the children in the study had more than one serious medical issue.
In the enhanced medical home, a physician and two pediatric nurse practitioners shared the primary care for each child. Parents could reach one of them at any time. The High-Risk Children's Clinic also has a nutritionist and a social worker on staff, and has visits from several types of specialists.
Over the course of two years, children using the enhanced medical home fell seriously ill about half as often as children receiving usual care. They were also half as likely to need to be hospitalized and two-thirds less likely to need to be admitted to an intensive care unit.
The enhanced medical home was also less expensive, at $16,500 for each year of care compared to nearly $27,000 for regular care.
Whether care coordinated at an enhanced medical home can be as beneficial for children who are not as severely ill remains to be studied.
The study was published in the Journal of the American Medical Association.
