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Preventive care and medical homes among US children with heart conditions

Published online by Cambridge University Press:  09 November 2020

Amber Broughton
Affiliation:
Rollins School of Public Health, Emory University, Atlanta, GA, USA
Tiffany Riehle-Colarusso
Affiliation:
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
Eric Nehl
Affiliation:
Rollins School of Public Health, Emory University, Atlanta, GA, USA
Aspen P. Riser
Affiliation:
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
Sherry L. Farr*
Affiliation:
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
*
Author for correspondence: Sherry Farr, PhD, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS 106-3, Atlanta, GA30341, USA. Tel: +1 404 498 3877; Fax: +1 404 498 3040. E-mail: [email protected]

Abstract

Within a medical home, primary care providers can identify needs, provide services, and coordinate care for children with heart conditions. Using parent-reported data from the 2016–2017 National Survey of Children’s Health, we examined receipt of preventive care in the last 12 months and having a medical home (care that is accessible, continuous, comprehensive, family-centred, coordinated, compassionate, and culturally effective) among US children aged 0–17 years with and without heart conditions. Using the marginal predictions approach to multivariable logistic regression, we examined associations between presence of a heart condition and receipt of preventive care and having a medical home. Among children with heart conditions, we evaluated associations between sociodemographic and health characteristics and receipt of preventive care and having a medical home. Of the 66,971 children included, 2.2% had heart conditions. Receipt of preventive care was reported for more children with heart conditions (91.0%) than without (82.7%) (adjusted prevalence ratio = 1.09, 95% confidence interval: 1.05–1.13). Less than half of children with heart conditions (48.2%) and without (49.5%) had a medical home (adjusted prevalence ratio = 1.02, 95% confidence interval: 0.91–1.14). For children with heart conditions, preventive care was slightly more common among younger children and less common among those with family incomes 200–399% of the federal poverty level. Having a medical home was less common among younger children, non-Hispanic “other” race, and those with ≥2 other health conditions. Most children with heart conditions received preventive care, but less than half had a medical home, with disparities by age, socioeconomic status, race, and concurrent health conditions. These findings highlight opportunities to improve care for children with heart conditions.

Type
Original Article
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Shumskiy, I, Richardson, T, Brar, S, et al. Well-child visits of Medicaid-insured children with medical complexity. J Pediatr 2018; 199: 223230.e2.CrossRefGoogle ScholarPubMed
Jenkins, K, Botto Lorenzo, D, Correa, A, et al. Public health approach to improve outcomes for congenital heart disease across the life span. J Am Heart Assoc 2019; 8: e009450.CrossRefGoogle ScholarPubMed
Lantin-Hermoso, MR, Berger, S, Bhatt, AB, et al. The care of children with congenital heart disease in their primary medical home. Pediatrics 2017; 140: e20172607.CrossRefGoogle ScholarPubMed
Long, WE, Bauchner, H, Sege, RD, et al. The value of the medical home for children without special health care needs. Pediatrics 2012; 129: 8798.CrossRefGoogle ScholarPubMed
Porterfield, SL, DeRigne, L. Medical home and out-of-pocket medical costs for children with special health care needs. Pediatrics 2011; 128: 892.CrossRefGoogle ScholarPubMed
Mosquera, RA, Avritscher, E, Samuels, CL, et al. Effect of an enhanced medical home on serious illness and cost of care among high-risk children with chronic illness: a randomized clinical trial. JAMA 2014; 312: 26402648.CrossRefGoogle ScholarPubMed
Downing, K, Oster, M, Farr, S. Preparing adolescents with heart problems for transition to adult care, 2009–2010 National Survey of Children with Special Health Care Needs. Congenit Heart Dis 2017; 12: 497506.CrossRefGoogle ScholarPubMed
Young, PC, Shyr, Y, Schork, MA. The role of the primary care physician in the care of children with serious heart disease. Pediatrics 1994; 94: 284.Google ScholarPubMed
Child and Adolescent Health Measurement Initiative. National Survey of Children’s Health (NSCH) [(SAS) Constructed Data Set]. Data Resource Center for Child and Adolescent Health supported by Cooperative Agreement U59MC27866 from the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). http://www.childhealthdata.org Google Scholar
Bethell, C.D., Kogan, M.D., Strickland, B.B., et al. A national and state profile of leading health problems and health care quality for US children: key insurance disparities and across-state variations. Acad Pediatr. 2011; 11: S22S33.CrossRefGoogle ScholarPubMed
Braveman, P, Egerter, S, Williams, DR. The social determinants of health: coming of age. Ann Rev Public Health 2011; 32: 381398.CrossRefGoogle ScholarPubMed
Braveman, P, Cubbin, C, Egerter, S, et al. Socioeconomic disparities in health in the United States: what the patterns tell us. Am J Public Health 2010; 100: S186S196.CrossRefGoogle ScholarPubMed
American Academy of Pediatrics. 2014 recommendations for pediatric preventive health care. Pediatrics 2014; 133: 568570.CrossRefGoogle Scholar
Morris, LS, Schettine, AM, Roohan, PJ, et al. Preventive care for chronically ill children in Medicaid managed care. Am J Manag Care 2011; 11: e435e442.Google Scholar
Mulvihill, BA, Altarac, M, Swaminathan, S, et al. Does access to a medical home differ according to child and family characteristics, including special-health-care-needs status, among children in Alabama? Pediatrics 2007; 119 (Suppl 1): S107.CrossRefGoogle ScholarPubMed
Singh, GK, Strickland, BB, Ghandour, RM, et al. Geographic disparities in access to the medical home among US CSHCN. Pediatrics 2009; 124 (Suppl 4): S352.CrossRefGoogle ScholarPubMed
Larson, K, Halfon, N. Family income gradients in the health and health care access of US children. Matern Child Health J 2010; 14: 332342.CrossRefGoogle ScholarPubMed
Van Cleave, J, Davis, MM. Preventive care utilization among children with and without special health care needs: associations with unmet need. Ambul Pediatr 2008; 8: 305311.CrossRefGoogle ScholarPubMed
Strickland, BB, Singh, GK, Kogan, MD, et al. Access to the medical home: new findings from the 2005–2006 national survey of children with special health care needs. Pediatrics 2009; 123: e996e1004.CrossRefGoogle ScholarPubMed
Lichstein, JC, Ghandour, RM, Mann, MY. Access to the medical home among children with and without special health care needs. Pediatrics 2018; 142: e20181795.CrossRefGoogle ScholarPubMed
Lin, C-W, Romley, JA, Carlin, C. The relationship between the patient-centered medical homes, healthcare expenditures, and quality of care among children with special health care needs. Matern Child Health J 2018; 22: 17511760.CrossRefGoogle ScholarPubMed
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