What is a medical home?

Through the medical home, primary care providers routinely address oral health and actively supporting referrals to dentistry, primary care teams elevate assessment and care of the teeth, gums, saliva, and oral mucosa to a status equal to that of every other organ system in the body. By actively coordinating referrals, primary care providers facilitate the kind of partnership with dentistry that is the standard among health professionals across disciplines.  Although pediatricians have the opportunity to provide early assessment of risk for dental caries and anticipatory guidance to prevent disease, it is also important that children establish a dental home. A dental home is the ongoing relationship between the dentist and the patient, inclusive of all aspects of oral health care delivered in a comprehensive, continuously accessible, coordinated, and family-centered way. (Krol, David M., et al.  Maintaining and Improving the Oral Health of Young Children. December 2014, Volume 134 / Issue 6).  The AAP, the American Academy of Pediatric Dentistry, the American Dental Association, and the American Association of Public Health Dentistry all recommend a dental visit for children by 1 year of age.  A Medical/Dental home provides primary care teams and dentists with the tools they need to improve oral health in partnership with the patients and families they serve (Qualis Health, Oral Health: An Essential Component of Primary Care White Paper, June 2015)

What is a “Medical Home”? 

A medical home is not a building or place; it extends beyond the walls of a clinical practice. A medical home builds partnerships with clinical specialists, families, and community resources. The medical home recognizes the family as a constant in a child’s life and emphasizes partnership between health care professionals and families. 

A medical home is an approach to providing comprehensive and high quality primary care. A medical home should be the following:

  • Accessible: Care is easy for the child and family to obtain, including geographic access and insurance accommodation.
  • Family-centered: The family is recognized and acknowledged as the primary caregiver and support for the child, ensuring that all medical decisions are made in true partnership with the family.
  • Continuous: The same primary care clinician cares for the child from infancy through young adulthood, providing assistance and support to transition to adult care.
  • Comprehensive: Preventive, primary, and specialty care are provided to the child and family.
  • Coordinated: A care plan is created in partnership with the family and communicated with all health care clinicians and necessary community agencies and organizations.
  • Compassionate: Genuine concern for the well-being of a child and family are emphasized and addressed.
  • Culturally Effective: The family and child’s culture, language, beliefs, and traditions are recognized, valued, and respected

Access to a pediatric medical home is associated with increased quality of care, improved health outcomes, and decreased unmet medical needs for children and youth, including children and youth with special health care needs. Research shows that access to and utilization of a pediatric medical home is associated with the following:

  • Increased provision of preventive services for children, such as the following:
    • Increased likelihood of having anticipatory guidance provided
    • Increased likelihood of being seen by a primary care clinician within the last year
    • Increased rates of childhood immunizations
    • Increased rates of well-child visits
    • Increased likelihood to have had height, weight, and blood pressure checked
  • Decreased amount of outpatient sick visits
  • Decreased rate of inappropriate use of antibiotics
  • Improved health outcomes and health status

Family-centered care is a key component of the medical home model. For pediatric populations, family-centered care is particularly important, given that families are the primary caregivers for children and youth. Research has shown that access to a clinical practice that is implementing family-centered care has positive impacts on family satisfaction. Research findings include the following:

  • Increased family satisfaction and positive parental experiences
  • Increased ability for families’ to meet day-to-day demands of parenthood
  • Decreased missed workdays for families
  • Decreased parental worry, increased family feedback

Resources
References
American Academy of Pediatrics, National Center for Medical Home Implementation

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