Abstract
Objective
To determine whether children with attention deficit/hyperactivity disorder (ADHD)
receive care in a patient-centered medical home (PCMH) and how that relates to their
ADHD treatment and functional outcomes.
Methods
Cross-sectional analysis of the 2007 National Survey for Children’s Health, a nationally
representative survey of 91,642 parents. This analysis covers 5169 children with parent-reported
ADHD ages 6–17. The independent variable is receiving care in a PCMH. Main outcome
measures are receiving ADHD medication, mental health specialist involvement, and
functional outcomes (difficulties with participation in activities, attending school,
making friends; having problem behaviors; missed school days; and number of times
parents contacted by school).
Results
Only 44% of children with ADHD received care in a PCMH. Children with ADHD receiving
care in a PCMH compared with those who did not were more likely to receive medication
for ADHD (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.1–1.9); less likely
to have mental health specialist involvement (OR, 0.6; 95% CI, 0.4–0.7); less likely
to have difficulties participating in activities (OR, 0.6; 95% CI 0.4–0.8), making
friends (OR, 0.6; 95% CI, 0.5–0.9), and attending school (OR, 0.4; 95% CI, 0.3−06);
less likely to have problem behaviors (OR 0.6; 95% CI 0.5–0.9); had fewer missed school
days (β = −1.5, 95% CI −2.4 to −0.5); and parents were contacted by school less frequently
(β = −0.2, 95% CI −0.3 to −0.1).
Conclusions
For children with ADHD, receiving care in a PCMH is associated with practice pattern
change and better outcomes. The PCMH may represent a promising opportunity to improve
quality of care and outcomes for children with ADHD.
Keywords
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Article Info
Publication History
Published online: October 04, 2011
Accepted:
August 29,
2011
Received:
April 20,
2011
Footnotes
The authors have no conflicts of interest to disclose.
Identification
Copyright
© 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
