Quality medical homes: Meeting children's needs for therapeutic and supportive services
Quality medical homes: Meeting children's needs for therapeutic and supportive services
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DOI：
10.1542/peds.2007-0066
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发表时间：
2008-01-01
期刊：
影响因子：
8
通讯作者：
Benedict, Ruth E.
中科院分区：
文献类型：
--
作者：
Benedict, Ruth E.
客观的。本研究的目的是确定医疗之家的质量是否与有特殊医疗保健需求的儿童获得所需的治疗和支持服务有关。方法。分析中使用了 2000-2001 年全国有特殊医疗保健需求儿童调查的数据。主要关注群体是 0 至 17 岁且需要治疗 (n = 15 793) 或支持 (n = 23 376) 服务的儿童。针对优质医疗之家的每个特征，生成了需要并接受治疗和支持服务的儿童的百分比。使用逻辑回归来控制协变量，同时对儿童医疗之家的整体质量与未满足的治疗或支持服务需求之间的关联进行建模。结果。在所有被确定需要服务的儿童中，16.2% 的治疗需求未得到满足，9.8% 的支持服务需求未得到满足。只有 23.9% 需要治疗的儿童和 32.5% 需要支持服务的儿童符合拥有优质医疗之家的标准。医疗之家内的高质量护理与治疗和支持服务需求未得到满足的可能性降低相关。优质医疗之家的每个特征都与未满足的需求相关，例如孩子病情的严重程度、家庭收入等。
OBJECTIVE. The objective of this study was to determine whether the quality of a medical home is associated with access to needed therapeutic and supportive services among children with special health care needs.METHODS. Data from the 2000-2001 National Survey of Children With Special Health Care Needs were used in the analysis. The primary group of interest was children who were 0 to 17 years of age and needed therapeutic (n = 15 793) or supportive (n = 23 376) services. For each characteristic of a quality medical home, the percentage of children who needed and received therapeutic and supportive services was generated. Logistic regression was used to control for covariates while modeling the association between overall quality of a child's medical home and having unmet needs for therapeutic or supportive services.RESULTS. Of all children identified as needing services, 16.2% had unmet therapeutic and 9.8% unmet supportive service needs. Only 23.9% of the children who needed therapeutic and 32.5% of children who needed supportive services met the criteria of having a quality medical home. High-quality care within medical homes was associated with a decreased likelihood of having unmet needs for therapeutic and supportive services. Each characteristic of a quality medical home was associated with unmet need, as were severity of the child's condition, family income of