Enhanced Medical Homes Improve Outcomes For Seriously Ill Children

Dr. Ricardo Mosquera MD Assistant professor of Pediatrics at The University of Texas Health Science Center at Houston Medical School Clinic Director, UT Physicians, of the UTHealth Medical School.MedicalResearch.com Interview with:
Dr. Ricardo Mosquera MD
Assistant professor of Pediatrics at The University of Texas Health Science Center at Houston Medical School
Clinic Director, UT Physicians, of the UTHealth Medical School.

Medical Research: What is the background for this study? What are the main findings?

Dr. Mosquera: There is not strong scientific evidence to support the use of medical homes.  Medical homes have not been demonstrated to decrease adverse outcomes or costs in children. Such benefits are most likely for high-risk children with chronic illness.  We conducted a rigorous and well designed, randomized controlled trial to determine if an enhanced medical home providing comprehensive care decreases serious illness  (death, prolonged hospitalization>7 days, or intensive care unit admissions) and/or cost among high-risk chronically ill children.

An enhanced medical home decreased both adverse outcomes (decreased serious illness, hospitalizations, PICU admissions, and serious illness by ~50%) and cost (~$10.000 less per child/year).

Medical Research: What should clinicians and patients take away from your report?

Dr. Mosquera: Among high-risk children with chronic illness, an enhanced medical home that provided comprehensive care to promote prompt effective care compared with the usual care reduced serious illnesses and costs. Healthcare payers need to invest in and support medical homes that can save money in the long term.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Mosquera: These findings require study in large, broader populations before conclusions about generalizability to other settings can be reached.

Citation:

Mosquera RA, Avritscher EC, Samuels CL, et al. Effect of an Enhanced Medical Home on Serious Illness and Cost of Care Among High-Risk Children With Chronic Illness: A Randomized Clinical Trial. JAMA. 2014;312(24):2640-2648. doi:10.1001/jama.2014.16419.

 

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