Percentage of infants/toddlers who received coordinated, ongoing, comprehensive care within a medical home

Percentage of infants/toddlers who received coordinated, ongoing, comprehensive care within a medical home

The American Academy of Pediatrics defines a medical home as a health care model that is “accessible, family-centered, continuous, comprehensive, coordinated, compassionate, and culturally effective.” Having a medical home is associated with improved health outcomes and healthy behaviors, as well as decreased sick and emergency room visits for children without special healthcare needs. Medical homes are also linked to better health status and increases to family functioning for children with special health care needs. The denominator is children ages 0-2. The numerator is children ages 0-2 whose parents affirmed the following items: their child has a personal doctor or nurse, a usual source for sick care, family-centered care, no problems getting needed referrals (if applicable) and effective care coordination when needed (if applicable). Estimates in the State of Babies Yearbook: 2022 are based on a four-year (2016-2019) combined sample of the National Survey of Children’s Health (NSCH). These results are more reliable than the results presented in the 2021 yearbook, which were based on three years of NSCH data (2016-2018). They should be considered improved estimates, not new estimates that can be compared directly to previous yearbook estimates. This indicator can be disaggregated by race/ethnicity and household income. Race/ethnicity: The child’s race/ethnicity is reported by their caregiver, and the included subgroups are Hispanic of all races, non-Hispanic White, non-Hispanic Black, and non-Hispanic Asian. The US Census Bureau recommends against using state or national population estimates for the following groups with the NSCH since these categories are not controlled independently: American Indian or Alaska Native, Hawaiian or Pacific Islander, and some “other” and “two or more races” categories, so those estimates are not presented. In 2019, the “some other race” race category was removed from the questionnaire. Missing responses were imputed and categorized into existing race groups. Household income: NSCH derives household income-to-poverty ratios based on family income and household size. Missing values were imputed by the Census Bureau, and the single imputation version provided in the 2016-2019 data files is used. Households with incomes less than 200 percent of the federal poverty line are classified as low-income. Households with incomes at or above 200 percent of the federal poverty line are classified as “not low-income.”

National Resource Center for Patient/Family-Centered Medical Home. (2020). What is medical home? https://medicalhomeinfo.aap.org/overview/Pages/Whatisthemedicalhome.aspx Long, W. E., Bauchner, H., Sege, R. D., Cabral, H. J., & Garg, A. (2012). The value of the medical home for children without special health care needs. Pediatrics, 129(1), 87-98. https://pediatrics.aappublications.org/content/129/1/87?ijkey=9ab7a63be22b823793d6c92ad721129ebf98c0fe&keytype2=tf_ipsecsha Homer, C. J., Klatka, K., Romm, D., Kuhlthau, K., Bloom, S., Newacheck, P., Van Cleave, J. & Perrin, J. M. (2008). A review of the evidence for the medical home for children with special health care needs. Pediatrics, 122(4), e922-e937. https://pediatrics.aappublications.org/content/122/4/e922?ijkey=809ac017f019f89122cb130b06716342cf7c08ab&keytype2=tf_ipsecsha

Sources:
Child and Adolescent Health Measurement Initiative. (2017). 2016 National Survey of Children’s Health (NSCH) Stata 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). www.childhealthdata.org
Child and Adolescent Health Measurement Initiative. (2018). 2017 National Survey of Children’s Health (NSCH) Stata 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). www.childhealthdata.org
Child and Adolescent Health Measurement Initiative. (2019). 2018 National Survey of Children’s Health (NSCH) Stata 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). www.childhealthdata.org
Child and Adolescent Health Measurement Initiative. (2020). 2019 National Survey of Children’s Health (NSCH) Stata 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). www.childhealthdata.org

Not Ranked
This indicator does not factor into the category's GROW ranking.