THE FAMILY-CENTERED MEDICAL HOME AND PARENTAL REPORT OF ACCESS TO SUPPORTIVE HEALTHCARE SERVICES AMONG CHILDREN WITH AUTISM SPECTRUM DISORDER, NATIONAL SURVEY OF CHILDREN WITH SPECIAL HEALTHCARE NEEDS

Date

2014-03

Authors

Davis, Ann M.
Brown, Lindsey M.
Suzuki, Sumihiro

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Abstract

Purpose (a): Autism Spectrum Disorder (ASD) is diagnosed among 1 in 88 children in the United States. These children have complex healthcare needs that may be well served in a family-centered medical home (FCMH) model. FCMHs provide comprehensive medical care that encourages partnerships between patients, families, and healthcare providers in effort to facilitate care that is accessible, compassionate, and family-centered. The primary purpose of this research was to examine the associations between having a FCMH and impact on access to supportive healthcare care for families with a child with ASD. Although multiple studies have examined effects of FCMH on children with special healthcare needs, few have specifically examined the relationship for ASD children. Methods (b): Data was obtained from the 2009-2010 National Survey of Children with Special Healthcare Needs (CSHN), a national telephone survey of households with children identified as special needs. Unadjusted and adjusted multivariate logistic regression was performed to determine the association between report of having a FCMH and report of unmet needs for healthcare or health services, respite care, communication equipment when needed, family support services, respite care, mental healthcare, and report of frustration with access to health-related services. Results (c): The study population consisted of 3,055 children (age 0-17) with parent reported ASD. The majority of the study population was between the ages of 6-11 (46.4%), male (80.6%), non-Hispanic white (72.1%), and had mild ASD (49.1%). About one quarter (23.1%) have care that is considered part of a FCMH. Those with a FCMH were less likely to report having an unmet healthcare or health service need (OR=0.170, 95%CI 0.117-0.245), having an unmet therapy need (OR=0.115,95%CI 0.068-0.194) and parent-reported frustration with coordination of care (OR=0.147,95% CI 0.089-0.240). Having a FCMH was not significantly associated with receipt of communication equipment when needed (OR=0.526, 95% CI 0.210-1.315) or receipt of respite care when needed (OR=1.281,95% CI 0.771-2.128) when adjusting for age, gender, race, ethnicity, type of insurance, having a usual source of care, primary spoken language, poverty level and state of residence. Conclusions (d): The FCMH was positively associated with improved access to supportive healthcare for families with a child with ASD. Future studies should examine this population to determine reasons behind the lack of usage.

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