Issues with the survey-based measure for patient centered medical homes for children
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Brief (State Health Access Data Assistance Center, University of Minnesota. State Health Access Reform Evaluation)
- Author(s):
- Lynch, Victoria, author Clemens-Cope, Lisa, author
- Contributor(s):
- Robert Wood Johnson Foundation, issuing body. State Health Access Data Assistance Center, University of Minnesota. State Health Access Reform Evaluation, issuing body.
- Publication:
- [Minneapolis, Minn.] : State Health Access Reform Evaluation, 2014
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Child Health Services Health Surveys -- methods Outcome Assessment (Health Care) -- methods Patient-Centered Care Child Models, Organizational Quality of Health Care Humans United States United States.
- Genre(s):
- Technical Report
- Abstract:
- Several provisions of the Affordable Care Act (ACA) are directed at the establishment and promotion of the Patient Centered Medical Home (PCMH), a model for evaluating health care quality that originated in the field of pediatrics. With this increasing emphasis on the PCMH concept, it is important to ensure policymakers have a valid measure for evaluating it, particularly at the state level, which is where national policy goals are primarily evaluated. This brief considers the current standard measure used to study the patient centered medical home (PCMH) for children in the National Survey of Children's Health (NSCH) and the National Survey of Children with Special Health Care Needs (NS-CSHCN). Using this composite measure as it is currently computed, children with special health care needs (CSHCN) are less likely to be identified as having a medical home compared to children without such needs. However, the treatment of missing information in the surveys calls this finding into question. This is because non-response due to inapplicability for any of the PCMH composite domains is treated as through the criterion for that domain is satisfied, and well-children have substantially more of this non-response. In addition, this treatment means that states with a higher proportion of children needing the range of services covered by the PCMH domains will appear to have lower proportions of children with a medical home compared to states with a lower proportion of these needy children, everything else being equal. The authors call for a revision to the current standard PCMH measure and suggest that, as computed, it should be interpreted as a measure of whether the medical care that children received conformed to the PCMH model as far as it could be measured given the rage of care the children received. While the authors acknowledge that there are no simple solutions to this measurement issue, their findings should be taken into consideration when designing and interpreting survey measures of PCMH, whether for children or adults, particularly as the PCMH gains broader traction under health reform.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-DC license. (More information)
- Extent:
- 1 online resource (1 PDF file (8 pages))
- NLM Unique ID:
- 101635618 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101635618