Access to Patient-Centered medical homes in children with sickle cell disease

Robert I. Liem*, Chibuzo O'Suoji, Paris S. Kingsberry, Stephanie A. Pelligra, Soyang Kwon, Maryann Mason, Alexis A. Thompson

*Corresponding author for this work

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

To determine the proportion of children with sickle cell disease (SCD) followed in a subspecialty clinic with access to a primary care provider (PCP) exhibiting practice-level qualities of a patient-centered medical home (PCMH). We surveyed 200 parents/guardians of children with SCD using a 44-item tool addressing PCP access, caregiver attitudes toward PCPs, barriers to healthcare utilization, perceived disease severity, and satisfaction with care received in the PCP versus SCD clinic settings. Individual PCMH criteria measured were a personal provider relationship and medical care characterized as accessible, comprehensive and coordinated. Although 94 % of respondents reported a PCP for their child, there was greater variation in the proportion of PCPs who met other individual PCMH criteria. A higher proportion of PCPs met criteria for coordinated care when compared to accessible or comprehensive care. In multivariate models, transportation availability, lower ER visit frequency and greater PCP visit frequency were associated favorably with having a PCP meeting criteria for accessible and coordinated care. Child and respondent demographics and disease severity had no impact on PCMH designation. Average respondent satisfaction scores for the SCD clinic was higher, when compared to satisfaction scores for the PCP. For children with SCD, access to a PCP is not synonymous with access to a medical home. While specific factors associated with PCMH access may be identified in children with SCD, their cause and effect relationships need further study.

Original languageEnglish (US)
Pages (from-to)1854-1862
Number of pages9
JournalMaternal and child health journal
Volume18
Issue number8
DOIs
StatePublished - Oct 1 2014

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Patient-Centered Care
Sickle Cell Anemia
Primary Health Care
Caregivers
Parents
Demography
Delivery of Health Care

Keywords

  • Healthcare access
  • Medical home
  • Primary care provider
  • Sickle cell disease

ASJC Scopus subject areas

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

Cite this

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abstract = "To determine the proportion of children with sickle cell disease (SCD) followed in a subspecialty clinic with access to a primary care provider (PCP) exhibiting practice-level qualities of a patient-centered medical home (PCMH). We surveyed 200 parents/guardians of children with SCD using a 44-item tool addressing PCP access, caregiver attitudes toward PCPs, barriers to healthcare utilization, perceived disease severity, and satisfaction with care received in the PCP versus SCD clinic settings. Individual PCMH criteria measured were a personal provider relationship and medical care characterized as accessible, comprehensive and coordinated. Although 94 {\%} of respondents reported a PCP for their child, there was greater variation in the proportion of PCPs who met other individual PCMH criteria. A higher proportion of PCPs met criteria for coordinated care when compared to accessible or comprehensive care. In multivariate models, transportation availability, lower ER visit frequency and greater PCP visit frequency were associated favorably with having a PCP meeting criteria for accessible and coordinated care. Child and respondent demographics and disease severity had no impact on PCMH designation. Average respondent satisfaction scores for the SCD clinic was higher, when compared to satisfaction scores for the PCP. For children with SCD, access to a PCP is not synonymous with access to a medical home. While specific factors associated with PCMH access may be identified in children with SCD, their cause and effect relationships need further study.",
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Access to Patient-Centered medical homes in children with sickle cell disease. / Liem, Robert I.; O'Suoji, Chibuzo; Kingsberry, Paris S.; Pelligra, Stephanie A.; Kwon, Soyang; Mason, Maryann; Thompson, Alexis A.

In: Maternal and child health journal, Vol. 18, No. 8, 01.10.2014, p. 1854-1862.

Research output: Contribution to journalArticle

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AU - Liem, Robert I.

AU - O'Suoji, Chibuzo

AU - Kingsberry, Paris S.

AU - Pelligra, Stephanie A.

AU - Kwon, Soyang

AU - Mason, Maryann

AU - Thompson, Alexis A.

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