The relationship between the medical home and unmet needs for children with autism spectrum disorders

Janet E. Farmer, Mary J. Clark, Wayne A. Mayfield, Nancy Cheak-Zamora, Alison R. Marvin, J. Kiely Law, Paul A. Law

Research output: Contribution to journalArticlepeer-review

50 Scopus citations

Abstract

The purpose of this study was to examine the relationship between having access to a medical home and unmet needs for specialty care services for children with autism spectrum disorders (ASD). Parents of children enrolled in a national autism registry were invited to complete an online Access to Care Questionnaire. The resulting sample consisted of 371 parents-child dyads. Bivariate and hierarchical regression analyses were conducted to determine whether having a medical home was associated with the number of unmet needs for specialty care. Less than one in five children with ASD had a medical home (18.9 %). Nearly all parents reported that their child had a personal doctor or nurse as well as a usual source of care, but less than one-third received coordinated care (29.9 %) and less than one-half received family-centered care (47.1 %). Many children had unmet needs (63 %), and the highest unmet need was for behavioral therapy. Having a medical home was associated with fewer unmet specialty care needs, even after demographic, child and family characteristics were taken into account. Children with ASD who have a medical home are more likely to have adequate access to needed services. Unfortunately, relatively few children have a medical home that includes family-centered and coordinated care. Enhancements in the delivery of primary care for children with ASD may make a real difference in access to needed specialty care services, potentially improving child and family outcomes.

Original languageEnglish (US)
Pages (from-to)672-680
Number of pages9
JournalMaternal and child health journal
Volume18
Issue number3
DOIs
StatePublished - Apr 2014

Keywords

  • Autistic disorder
  • Delivery of health care
  • Health services
  • Medical home
  • Patient-centered care

ASJC Scopus subject areas

  • Epidemiology
  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health

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