The Journal of Pediatrics
Volume 156, Issue 6 , Pages 1006-1010 , June 2010

Benefits of Care Coordination for Children with Complex Disease: A Pilot Medical Home Project in a Resident Teaching Clinic

  • Thomas S. Klitzner, MD, PhD

      Affiliations

    • Mattel Children's Hospital, Pediatrics, University of California Los Angeles, Los Angeles, CA
    • Corresponding Author InformationReprint requests: Thomas S. Klitzner, MD, PhD, Jack H. Skirball Professor of Pediatrics, David Geffen School of Medicine at UCLA, Box 951743, 10833 Le Conte Ave, B2-427 MDCC, Los Angeles, CA 90095-1743.
  • ,
  • Leslie A. Rabbitt, MPH

      Affiliations

    • Pediatrics, CHOC Children's Hospital Orange, CA
  • ,
  • Ruey-Kang R. Chang, MD, MPH

      Affiliations

    • Pediatrics, Harbor-University of California Los Angeles Medical Center, Los Angeles, CA

Received 19 June 2009 ,Revised 12 October 2009 ,Accepted 7 December 2009.

References 

  1. Sia C, Tonniges TF, Osterhus E, Taba S. History of the medical home concept. Pediatrics. 2004;113:1473–1478
  2. Nageswaran S, Roth M, Kluttz-Hile C, Farel A. Medical homes for children with special healthcare needs in North Carolina. NC Med J. 2006;67:103–109
  3. Kieckhefer G, Greek A, Joesch J, Kim H, Baydar N. Presence and characteristics of medical home and health services utilization among children with asthma. J Pediatr Health Care. 2005;19:285–292
  4. Liptak GS, Burns CM, Davidson PW, McAraney ER. Effects of providing comprehensive ambulatory services to children with chronic conditions. Arch Pediatr Adolesc Med. 1998;52:1003–1008
  5. Gordon JB, Colby HH, Bartelt T, Jablonski D, Krauthoefer ML, Havens P. A tertiary care-primary care partnership model for medically complex and fragile children and youth with special health care needs. Arch Pediatr Adolesc Med. 2007;161:930–932
  6. Kelly A, Golnik A, Cady R. A medical home center: specializing in the care of children with special health care needs of high intensity. Matern Child Health J. 2008;12:633–640
  7. Cooley WC, McAllister JW, Sherrieb K, Kuhlthau K. Improved outcomes associated with medical home implementation in pediatric primary care. Pediatrics. 2009;124:358–364
  8. Farmer JE, Clark MJ, Sherman A, Marien WE, Selva TJ. Comprehensive primary care for children with special health care needs in rural areas. Pediatrics. 2005;116:649–656
  9. Antonelli RC, Stille CJ, Antonelli DM. Care coordination for youth with special health care needs: a descriptive multisite study of activities, personnel, costs and outcomes. Pediatrics. 2008;122:e209–e216
  10. McManus M, Fox H, Limb S, Arango P, Armstrong P, Azizkhan R, et al. New workforce, practice, and payment reforms essential for improving access to pediatric subspecialty care within the medical home. Arch Pediatr Adolesc Med. 2009;163:200–202
  11. Lister G, Murdock-Vlautin TC, Friedman AL. Report of colloquium I: the future of pediatric health care delivery and education–pondering imponderables to create an ideal residency in a world of critical uncertainties. Pediatrics. 2009;123:S12–S16
  12. Berman S, Rannie M, Moore L, Elias E, Dryer L, Jones M. Utilization and costs for children who have special health care needs and are enrolled in a hospital based comprehensive primary care clinic. Pediatrics. 2005;115:e637–e642
  13. Palfrey JS, Sofis LA, Davidson EJ, Liu J, Freeman L, Ganz ML. Pediatric Alliance for Coordinated Care. The Pediatric Alliance for Coordinated Care: evaluation of a medical home model. Pediatrics. 2004;113(Suppl):1507–1516
  14. Homer CJ, Klatka K, Romm D, Kuhlthau K, Bloom S, Newacheck P, et al. A review of the evidence for the medical home for children with special health care needs. Pediatrics. 2009;123:e369
  15. Palfrey JS, Hametz P, Grason H, McCaskill QE, Scott G, Chi GW. Educating the next generation of pediatricians in urban health care: the Anne E. Dyson Community Pediatrics Training Initiative. Acad Med. 2004;79:1184–1191
  16. Freed GL, Dunham KM, Switalski KE, Jones MD, McGuinness GA. Research Advisory Committee of the American Board of Pediatrics. Pediatric fellows: perspectives on training and future scope of practice. Pediatrics. 2009;123:S31–S37
  17. Medical Home Initiatives for Children with Special Needs Project Advisory Committee. American Academy of Pediatrics. The medical home. Pediatrics. 2002;110:84–86
  18. Cooley WC. American Academy of Pediatrics Committee on Children with Disabilities. Providing a primary care medical home for children and youth with cerebral palsy. Pediatrics. 2004;114:1106–1113
  19. American Academy of Pediatrics. Committee on Pediatric Emergency Medicine. The emergency physician and the office-based pediatrician: an EMSC team. Pediatrics. 1998;101:936–937
  20. Wang C, Villar ME, Mulligan DA, Hansen T. Cost and utilization analysis of a pediatric emergency department diversion project. Pediatrics. 2005;116:1075–1079
  21. McBurney PG, Simpson KN, Darden PM. Potential cost savings of decreased emergency department visits through increased continuity in a pediatric medical home. Ambul Pediatr. 2004;3:204–208
  22. Olesen F, Jolleys JV. Out of hours service: the Danish solution examined. BMJ. 1994;309:1624–1626
  23. Coleman EA, Eilertsen TB, Kramer AM, Magid DJ, Beck A, Conner D. Reducing emergency visits in older adults with chronic illness. A randomized, controlled trial of group visits. Eff Clin Pract. 2001;4:49–57
  24. Brousseau DC, Hoffmann RG, Nattinger AB, Flores G, Zhang Y, Gorelick M. Quality of primary care and subsequent pediatric emergency department utilization. Pediatrics. 2007;119:1131–1138
  25. Flores G, Vega LR. Barriers to health care access for Latino children: a review. Fam Med. 1998;30:196–205
  26. Redlener I, Grant R, Krol DM. Beyond primary care: ensuring access to subspecialists, special services, and health care systems for medically underserved children. Adv Pediatr. 2005;52:9–22
  27. Lemak CH, Johnson C, Goodrick EE. Collaboration to improve services for the uninsured: exploring the concept of health navigators as interorganizational integrators. Health Care Manage Rev. 2004;29:196–206
  28. Pollack HA, Dombkowski KJ, Zimmerman JB, Davis MM, Cowan AE, Wheeler JR, et al. Emergency department use among Michigan children with special health care needs: an introductory study. Health Serv Res. 2004;39:665
  29. Haughton JG. Emergency services: part of the safety net?. J Public Health Policy. 2005;26:282–285
  30. Brandon WR, Chambers R. Reducing emergency department visits among high-using patients. J Fam Pract. 2003;52:637–640
  31. Sobo EJ, Seid M, Reyes Gelhard L. Parent-identified barriers to pediatric health care: a process-oriented model. Health Serv Res. 2006;41:148–172

 The Pediatric Medical Home Project at UCLA for Children with Special Health Care Needs has been supported by a Healthy Tomorrows Partnership for Children grant from the American Academy of Pediatrics and the Health Resources and Services Administration (H17MC00406), and a grant from the Skirball Foundation. The authors declare no conflicts of interest.

PII: S0022-3476(09)01240-2

doi: 10.1016/j.jpeds.2009.12.012

The Journal of Pediatrics
Volume 156, Issue 6 , Pages 1006-1010 , June 2010