South Carolina Public Health Consortium, Arnold School of Public Health, University of South Carolina, 800 Sumter Street, Suite 309, Columbia, SC 29208, USA.
Med Care Res Rev. 2010 Aug;67(4):450-75. doi: 10.1177/1077558710367735. Epub 2010 May 4.
This study examined data from the 2005-2006 National Survey of Children with Special Health Care Needs to assess the relationship among children with asthma between a reported medical home and emergency department (ED) use. The authors used 21 questions to measure 6 medical home components: personal doctor/nurse, family-centered, compassionate, culturally effective and comprehensive care, and effective care coordination. Weighted zero-inflated Poisson regression analyses assessed the independent effects of having a medical home on annual number of child ED visits while controlling for child and parental characteristics, and the differential likelihood of securing a medical home. Nearly half (49.9%) of asthmatic children had a medical home. Receiving primary care in a medical home was associated with fewer ED visits (incidence rate ratio = 0.93; 95% confidence interval = 0.89-0.97). A medical home in which physicians and parents share responsibility for ensuring that children have access to needed services may improve child and family outcomes for children with asthma.
这项研究调查了 2005-2006 年全国有特殊健康需求儿童调查的数据,以评估哮喘儿童与报告的医疗之家和急诊室 (ED) 使用之间的关系。作者使用 21 个问题来衡量 6 个医疗之家的组成部分:私人医生/护士、以家庭为中心、富有同情心、文化上有效和全面的护理以及有效的护理协调。加权零膨胀泊松回归分析评估了在控制儿童和父母特征的情况下,拥有医疗之家对儿童每年急诊就诊次数的独立影响,以及获得医疗之家的可能性差异。近一半(49.9%)的哮喘儿童有医疗之家。在医疗之家接受初级保健与急诊就诊次数较少相关(发病率比=0.93;95%置信区间=0.89-0.97)。医生和父母共同负责确保儿童获得所需服务的医疗之家可能会改善哮喘儿童的儿童和家庭结局。