Relationship of Medical Home Components With Health Care Utilization and Unmet Needs in Children and Youth With Special Health Care Needs
Abstract
Background and Objective: The medical home is a primary care model that offers comprehensive, uninterrupted, and family-centered care to children regardless of their special health care needs. Although the overall contribution of medical home is well-studied, the differential influence of its components on health care utilization and unmet needs, particularly for children and youth with special health care needs (CYSHCN) remains insufficiently understood. This study examined the medical home component(s) that can best predict emergency and preventive visits, and unmet needs in CYSHCN. Methods: This study analyzed 2016−2022 National Survey of Children’s Health data from 64 553 caregivers of CYSHCN aged 0–17 years using the Rao–Scott Chi-square test and multivariable logistic regression. Results: Findings show that receiving care within an overall medical home was associated with lower odds of emergency visits [adjusted odds ratio (aOR): 0.77 (95% confidence interval: 0.70–0.84)] and unmet needs [aOR = 0.29 (0.24–0.34)], and higher odds of preventive dental visits [aOR = 1.40 (1.25–1.57)]. Having a usual source for sick care and receiving effective care coordination was associated with reduced odds of emergency visits (aOR = 0.74 [0.64-0.84] and aOR = 0.85 [0.77-0.95], respectively). Receiving family-centered care [aOR = 0.45 (0.38–0.54)], no problems getting needed referral [aOR = 0.58 (0.47–0.72)], and getting effective care coordination when needed [aOR = 0.32 (0.26–0.39)] were associated with lower odds of unmet needs. The odds of utilizing preventive medical and dental visits was higher with having a personal doctor or nurse [aOR = 1.42(1.12–1.80) and aOR = 1.41 (1.20–1.65), respectively] and receiving family-centered care [aOR = 1.59 (1.18–2.12) and aOR = 1.44 (1.22–1.71), respectively]. Conclusions: The study highlights the importance of considering the differential contribution of medical home components for reducing emergency visits, addressing unmet needs, and improving preventive care, providing insights to enhance health care delivery for CYSHCN.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Receipt of adequate care coordination is associated with reduced use of emergency room care.
“reduced use of emergency room care (Chowdhury et al., 2026)”
From Adequate Care Coordination is Associated with Reduced Unmet Mental Health Needs for Children (2026) · cites this paper as Chowdhury et al., 2026
Cites
A Review of the Evidence for the Medical Home for Children With Special Health Care Needs
Homer, C. J., Klatka, K., Romm, D., Kuhlthau, K., Bloom, S., Newacheck, P., Van Cleave, J., & Perrin, J. M. (2008) · Pediatrics · doi:10.1542/peds.2007-3762 · Cited by 373 · see citing works
The Design and Implementation of the 2016 National Survey of Children’s Health
Ghandour, R. M., Jones, J. R., Lebrun-Harris, L. A., Minnaert, J., Blumberg, S. J., Fields, J., Bethell, C., & Kogan, M. D. (2018) · Maternal and Child Health Journal · doi:10.1007/s10995-018-2526-x · Cited by 253 · see citing works
Improved Outcomes Associated With Medical Home Implementation in Pediatric Primary Care
Cooley, W. C., McAllister, J. W., Sherrieb, K., & Kuhlthau, K. A. (2009) · PEDIATRICS · doi:10.1542/peds.2008-2600 · Cited by 222 · see citing works
Strickland, B. B., Singh, G. K., Kogan, M. D., Mann, M. Y., van Dyck, P. C., & Newacheck, P. W. (2009) · PEDIATRICS · doi:10.1542/peds.2008-2504 · Cited by 144 · see citing works
Kuo, D. Z., Bird, T. M., & Tilford, J. M. (2011) · Maternal and Child Health Journal · doi:10.1007/s10995-010-0648-x · Cited by 139 · see citing works
Katz, E. B., Carrier, E. R., Umscheid, C. A., & Pines, J. M. (2012) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2012.02.025 · Cited by 118 · see citing works
Perrin, J. M., Romm, D., Bloom, S. R., Homer, C. J., Kuhlthau, K. A., Cooley, C., Duncan, P., Roberts, R., Sloyer, P. J., Wells, N., et al. (2007) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.161.10.933 · Cited by 107 · see citing works
The Value of the Medical Home for Children Without Special Health Care Needs
Long, W. E., Bauchner, H., Sege, R. D., Cabral, H., & Garg, A. (2011) · PEDIATRICS · doi:10.1542/peds.2011-1739 · Cited by 86 · see citing works
Emotional, developmental and behavioural co‐morbidities of children with chronic health conditions
Blackman, J. A., Gurka, M. J., Gurka, K. K., & Oliver, M. N. (2011) · Journal of Paediatrics and Child Health · doi:10.1111/j.1440-1754.2011.02044.x · Cited by 84 · see citing works
The Impact of the Medical Home on Access to Care for Children with Autism Spectrum Disorders
Cheak-Zamora, N. C., & Farmer, J. E. (2015) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-014-2218-3 · Cited by 68 · see citing works
Access to the Medical Home Among Children With and Without Special Health Care Needs
Lichstein, J. C., Ghandour, R. M., & Mann, M. Y. (2018) · PEDIATRICS · doi:10.1542/peds.2018-1795 · Cited by 61 · see citing works
Miller, J. E., Nugent, C. N., Gaboda, D., & Russell, L. B. (2013) · PLoS ONE · doi:10.1371/journal.pone.0082570 · Cited by 37 · see citing works
Akobirshoev, I., Parish, S. L., Mitra, M., & Dembo, R. (2019) · Maternal and Child Health Journal · doi:10.1007/s10995-019-02774-9 · Cited by 36 · see citing works
Zickafoose, J. S., & Davis, M. M. (2013) · Journal of Health Care for the Poor and Underserved · doi:10.1353/hpu.2013.0117 · Cited by 34 · see citing works
A Systematic Review of the Medical Home for Children Without Special Health Care Needs
Hadland, S. E., & Long, W. E. (2013) · Maternal and Child Health Journal · doi:10.1007/s10995-013-1315-9 · Cited by 34 · see citing works
Medical Home and Pediatric Primary Care Utilization Among Children With Special Health Care Needs
Willits, K. A., Platonova, E. A., Nies, M. A., Racine, E. F., Troutman, M., & Harris, H. L. (2012) · Journal of Pediatric Health Care · doi:10.1016/j.pedhc.2011.11.004 · Cited by 26 · see citing works
Graaf, G., & Gigli, K. (2022) · BMJ Open · doi:10.1136/bmjopen-2022-063373 · Cited by 24 · see citing works
Lin, S. C., Margolis, B., Yu, S. M., & Adirim, T. A. (2014) · Pediatric Emergency Care · doi:10.1097/pec.0000000000000184 · Cited by 22 · see citing works
Contributions of Key Components of a Medical Home on Child Health Outcomes
Arthur, N. S. M., & Blewett, L. A. (2022) · Maternal and Child Health Journal · doi:10.1007/s10995-022-03539-7 · Cited by 17 · see citing works
Medical Home and Emergency Department Utilization Among Children With Special Health Care Needs
Willits, K. A., Nies, M. A., Racine, E. F., Troutman‐Jordan, M., Platonova, E. A., & Harris, H. L. (2012) · Journal of Ambulatory Care Management · doi:10.1097/jac.0b013e318249c5ca · Cited by 11 · see citing works
The Medical Home and Mental Health Services in Children and Youth with Special Health Care Needs
Rast, J. E., Roux, A. M., Connor, G., Ezeh, T. H., Shea, L., Turchi, R. M., & Shattuck, P. T. (2023) · Maternal and Child Health Journal · doi:10.1007/s10995-023-03652-1 · Cited by 4 · see citing works
Chowdhury, S. K., Marshall, J. T., Zgibor, J. C., & Kirby, R. S. (2024) · Disability and health journal · doi:10.1016/j.dhjo.2024.101688 · Cited by 4 · see citing works
Self-citationChowdhury, S. K., Aydin, R. A., Puri, H., Sundaramurugan, S., Rao, N. R., Skinner, H., Sauls, R., Brice, D. J., Tsang, S., Bakour, C., et al. (2025) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000001343 · Cited by 2 · see citing works
Self-citationElger, R. S., Chowdhury, S. K., Garrillo, M. P., Sauls, R., Sundaramurugan, S., Rozen, E., Puri, H., Brice, D. J., Liu, J., Bakour, C., et al. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-024-06444-w · Cited by 1 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Adequate Care Coordination is Associated with Reduced Unmet Mental Health Needs for Children
Graaf, G., Gigli, K., Hughes, P., & Thomas, K. C. (2026) · Child and Adolescent Social Work Journal · doi:10.1007/s10560-026-01101-w
- Authors
- Chowdhury, S. K., Marshall, J., Boone, B., & Kirby, R. S.
- Affiliations
- University of South Florida (US)
- Corresponding author
- Chowdhury, Suman Kanti
- Venue
- Journal of Ambulatory Care Management
- Published
- 2025-11-24
- Volume
- 49
- Issue
- 1
- Pages
- E14-E30
- ISSN
- 0148-9917 (ISSN-L)
- 1550-3267
- OpenAlex
- W4416869259
- Cited by
- 1
- References
- 24
- Citations by year
- 2026: 1
- FWCI
- 1.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Ambulatory Care Management (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
- Keywords
- patient-centered medical home, children and youth with special health care needs, health care utilization, unmet health needs, emergency department visits, preventive dental visits, usual source of care, care coordination, family-centered care, primary care, National Survey of Children's Health, caregiver perspectives, health equity, social determinants of health, uninsured children
- MeSH terms
- Adolescent, Child, Child, Preschool, Female, Health Services Needs and Demand, Humans, Infant, Infant, Newborn, Male, Patient Acceptance of Health Care, United States, Patient-Centered Care, Children with Disabilities
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
