| Much attention has been invested in children with special health care needs (CSHCN). Care coordination can relieve the stress of navigating systems of care for families. If done successfully, care coordination should occur in the medical home. The current research evaluates the impact of a pilot medical home for CSHCN. The specific hypotheses are: (1) CSHCN, whose care is coordinated in a medical home, have better health outcomes, as demonstrated through health service behaviors, than CSHCN who do not have a medical home. (2) Health outcomes of CSHCN will improve after one year of intensive care coordination via a medical home.; The independent variable is participation in the medical home. The following are the dependent variables: (1) mean visit, length of stay, and paid claims rates for inpatient hospitalizations; (2) mean visit and paid claims rates for emergency room (ER) visits; and (3) mean well-child visit and paid claims rates. The Medicaid Management Information System (MMIS), used to determine eligibility for Medicaid and manage billing, is the data source used for the secondary analysis.; The comparison group was selected based on shared characteristics with the case group, but not matched at the individual level. The comparison group was selected from MMIS and consists of children similar in ages, diagnoses, racial orientations, Medicaid eligibility, gender, urban versus rural residence, billable case management services, and ER utilization during the pre-intervention year.; The descriptive analysis suggests that the medical home is influencing mean visit rates in ways that support the hypotheses, with the exception of inpatient hospitalizations. Poisson analyses support this conclusion, as evidenced by rate ratios for all ER visits, outpatient ER visits, and ER visits resulting in inpatient hospitalizations. Poisson analyses demonstrate no statistically significant differences between case and comparison groups. Chi-Square analyses demonstrate statistically significant differences only for the case group for emergency room visits resulting in inpatient hospitalizations from the pre-intervention to the intervention years. |
