A Medical Home Center: Specializing in the Care of Children with Special Health Care Needs of High Intensity
A Medical Home Center: Specializing in the Care of Children with Special Health Care Needs of High Intensity
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DOI：
10.1007/s10995-007-0271-7
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发表时间：
2008-09-01
影响因子：
2.3
通讯作者：
Cady, Rhonda
中科院分区：
文献类型：
--
作者：
Kelly, Anne;Golnik, Allison;Cady, Rhonda
目的：有特殊保健需要的儿童从医疗之家受益，然而，有高强度需求的儿童的医疗和社会服务问题超出了大多数初级保健实践的能力。我们描述了一个新颖的医疗家庭中心，旨在满足具有高强度特殊卫生保健需求的儿童的需求（CSHCN-HI）。医疗家庭中心，U Special Kids （USK）位于明尼苏达大学，隶属于三级医疗中心。USK在整个明尼苏达州为CSHCN-HI提供服务，由于国家支持该计划的资金，无论儿童的健康保险范围如何，他们都可以参加该计划。该小组擅长收集儿童需求的整体观点，确定差距，获得服务，并将大量不同的服务、机构和提供者编织在一起。该模式的一个主要目标是将护理从USK过渡到儿童社区内的初级保健医疗之家。一旦儿童的复杂需求得到组织，家庭得到培训，适当的管理资源到位，照料协调需求的强度降低，过渡就更有可能以最佳方式发生。我们认为，除了初级保健医疗之家外，CSHCN-HI还受益于一个独特的医疗之家中心，该中心可以提供足够的资源和专业知识来组织他们复杂的护理协调需求。医疗家庭中心是专门为管理具有复杂的高强度医疗和护理协调需求的儿童而设计的，有可能通过为这组儿童提供定制的、可获得的和综合的服务来减少过度的医疗保健利用并改善患者的治疗效果。
Objective Children with special health care needs (CSHCN) benefit from a medical home, however, a subset, those children with high intensity needs, have medical and social service issues beyond the capacity of most primary care practices. We describe a novel medical home center that is designed to meet the needs of children with special health care needs of high intensity (CSHCN-HI). Model of care The medical home center, U Special Kids (USK) is located at the University of Minnesota and affiliated with a tertiary medical center. USK serves CSHCN-HI throughout the state of Minnesota and, because of state supported funding for the program, children have access to the program regardless of their health insurance coverage. The team is expert at gathering an overall perspective of the child's needs, identifying gaps, accessing services and weaving together the plethora of disparate services, agencies and providers. A major goal of this model is to transition care from USK to a primary care medical home within the child's community. Transition is more likely to occur optimally once the child's complex needs are organized, the family is trained, adequate management resources are in place, and the intensity of care coordination needs are reduced. Conclusions We propose that, in addition to a primary care medical home, CSHCN-HI benefit from a unique medical home center that can provide sufficient resources and expertise to organize their complex care coordination needs. Medical home centers, designed specifically to manage the care of children with complex high intensity medical and care coordination needs, have the potential to reduce excess health care utilization and improve patient outcomes by providing this group of children with customized, accessible and integrated services.