Meeting Healthcare Needs of Children with Autism Spectrum Disorders: Family Centered Medical Home Matters




Davis, Ann M.
Homan, Sharon


Journal Title

Journal ISSN

Volume Title



Purpose: The prevalence of Autism Spectrum Disorders (ASD) has increased over the past decade. Children with ASD have complex healthcare needs that may be best served in a family-centered medical home (FCMH) model. A family-centered medical home provides effective primary health care that is accessible, family-centered, continuous, comprehensive, coordinated, compassionate and culturally competent. We examined whether having a FCMH increased the likelihood that children with ASD receive the therapy, mental health care, preventive services and specialty care they need. Methods: We conducted a cross-sectional national study of 3025 children (3 to 17 years) with parent-reported ASD. We analyzed data from the 2009-10 National Survey of Children with Special Health Care Needs (NS-CSHCN). We estimated the impact of having a medical home on receiving needed medical and non-medical therapy, mental health care, preventive services and specialty health care. Using the Andersen Model of Health Care Utilization as our conceptual framework, we fit hierarchically well formulated logistic regression models consisting of predisposing (P), enabling (E) and health need (N) variables as predictors of receiving needed healthcare services. We estimated the increased likelihood (odds ratio) of receiving needed services when the child has a FCMH versus no FCMH, adjusting for the P, E and N variables. Results: Only half of children with autism (51.8%) had healthcare that is considered part of a FCMH. Children with a FCMH were more likely to report receiving needed specialty care (OR=4.068, 95%CI 2.20-7.52), therapy (OR=1.754 95% CI 1.18 – 2.60) and mental health care (OR=2.74 95% CI 1.55 – 4.84). Having a FCMH was not significantly associated with receiving needed preventive health services. Each model was adjusted for predisposing factors (age, gender, race, family structure), enabling factors ( household education, poverty level, adequacy of current insurance, receipt of early intervention services, age at diagnosis) and need ( severity level, difficulty communicating). Conclusions: Having a FCMH significantly increased the likelihood that the healthcare needs of children with ASD were met, adjusting for relevant predisposing, enabling and need variables.