Building a medical home for children and youth with special health care needs

Abstract

Delivering high-quality, patient-/family-centered, and efficient care is the cornerstone of primary care. Packaging this care in the context of a medical home is the standard of health care delivery for children and adults. Central to delivering care in the medical home is a team-based approach to care. Early and continuous screening of children improves the health and well-being of the child beginning from birth and throughout his or her lifetime. Family-centered care is a central pillar to the medical home concept. Family-centered care is distinguished by the recognition that the family is the constant in a child's life, while the service systems and support personnel within those systems change. In addition, families' attitudes may reflect traditional family, ethnic, or cultural influences that approach the concept of illness and chronic conditions in different ways. A high- quality functioning medical home does not need to provide every service alone, but does require effective partnerships across various settings and the community via coordination across systems. Care coordination is also a hallmark of the medical home in practice. Information sharing can improve coordination of care. The pediatric clinician plays an important role in facilitating transition from pediatric-oriented to adult-oriented health care. Planning for transition should be a standard part of providing care for all youth and young adults, not just youth with special health care needs.