Kelly M Boone1, Mary Ann Nelin2, Deena J Chisolm3, Sarah A Keim4. 1. Schoenbaum Family Center and Crane Center for Early Childhood Research and Policy, The Ohio State University, Columbus, OH. Electronic address: boone.208@osu.edu. 2. Nationwide Children's Hospital, Columbus, OH; Division of Ambulatory Medicine, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH. 3. Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH; Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH. 4. Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH; Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Division of Epidemiology, College of Public Health, The Ohio State University; Columbus, OH.
Abstract
OBJECTIVE: To characterize gaps and factors related to receipt of care within a medical home for toddlers born preterm. STUDY DESIGN:Participants were 202 caregivers of children born at <35 weeks of gestation. At 10-16 months of corrected age, caregivers completed the National Survey of Children's Health (2011/2012) medical home module and a sociodemographic profile. Care within a medical home comprised having a personal doctor/nurse, a usual place for care, effective care coordination, family-centered care, and getting referrals when needed. Gestational age and neonatal follow-up clinic attendance were abstracted from the medical record. The Bayley Scales of Infant and Toddler Development, Third Edition assessed developmental status. Log-binomial regression examined factors related to receiving care within a medical home. RESULTS:Fifty-three percent (n = 107) of the children received care within a medical home. Low socioeconomic status (young caregiver: risk ratio [RR] = 0.73; 95% CI 0.55, 0.97; low education: RR= 0.69; 95% CI 0.49, 0.98) and delayed language (RR = 0.63; 95% CI 0.42, 0.95) were associated with a lower likelihood of receiving care within a medical home. Degree of prematurity and neonatal clinic follow-up participation were unrelated to receipt of care within a medical home. CONCLUSIONS: Receipt of care within a medical home was lacking for nearly one-half of preterm toddlers, especially those with lower socioeconomic status and poorer developmental status. Discharge from a neonatal intensive care unit may be an optimal time to facilitate access to a primary care medical home and establish continuity of care. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01576783.
RCT Entities:
OBJECTIVE: To characterize gaps and factors related to receipt of care within a medical home for toddlers born preterm. STUDY DESIGN:Participants were 202 caregivers of children born at <35 weeks of gestation. At 10-16 months of corrected age, caregivers completed the National Survey of Children's Health (2011/2012) medical home module and a sociodemographic profile. Care within a medical home comprised having a personal doctor/nurse, a usual place for care, effective care coordination, family-centered care, and getting referrals when needed. Gestational age and neonatal follow-up clinic attendance were abstracted from the medical record. The Bayley Scales of Infant and Toddler Development, Third Edition assessed developmental status. Log-binomial regression examined factors related to receiving care within a medical home. RESULTS: Fifty-three percent (n = 107) of the children received care within a medical home. Low socioeconomic status (young caregiver: risk ratio [RR] = 0.73; 95% CI 0.55, 0.97; low education: RR= 0.69; 95% CI 0.49, 0.98) and delayed language (RR = 0.63; 95% CI 0.42, 0.95) were associated with a lower likelihood of receiving care within a medical home. Degree of prematurity and neonatal clinic follow-up participation were unrelated to receipt of care within a medical home. CONCLUSIONS: Receipt of care within a medical home was lacking for nearly one-half of preterm toddlers, especially those with lower socioeconomic status and poorer developmental status. Discharge from a neonatal intensive care unit may be an optimal time to facilitate access to a primary care medical home and establish continuity of care. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01576783.
Authors: Jeanne Van Cleave; Megumi J Okumura; Nancy Swigonski; Karen G O'Connor; Marie Mann; Jennifer L Lail Journal: Acad Pediatr Date: 2015-10-30 Impact factor: 3.107
Authors: Joseph M Collaco; Michael C Tracy; Catherine A Sheils; Jessica L Rice; Lawrence M Rhein; Leif D Nelin; Paul E Moore; Winston M Manimtim; Jonathan C Levin; Khanh Lai; Lystra P Hayden; Julie L Fierro; Eric D Austin; Stamatia Alexiou; Amit Agarwal; Natalie Villafranco; Roopa Siddaiah; Antonia P Popova; Ioana A Cristea; Christopher D Baker; Manvi Bansal; Sharon A McGrath-Morrow Journal: Pediatr Pulmonol Date: 2022-04-26