Social Complexity as a Special Health Care Need in the Medical Home Model.

Abstract

* Abbreviations: CSHCN — : children with special health care needs SHCN — : special health care needs A comprehensive medical home is considered the foundation of quality primary care services for all children, particularly for those with special health care needs (SHCN).1,2 In the article “Access to the Medical Home Among Children With and Without Special Health Care Needs,”3 the authors describe results from the 2016 National Survey of Children’s Health, which revealed that children with special health care needs (CSHCN) were less likely than non-CSHCN to receive primary care that meets the medical home criteria3 of having a usual source of care, having a personal doctor or nurse, receiving necessary referrals, receiving needed care coordination, and receiving family-centered care.4 In addition, CSHCN with more qualifiers for SHCN status (a marker of higher medical complexity) are less likely to have access to a medical home than children with fewer SHCN qualifiers. However, CSHCN were more likely than non-CSHCN to have a usual source of care or personal doctor or nurse.3 Because less than half of the children surveyed had access to care in a medical home, it is clear that there are barriers within the current … Address correspondence to Molly Fuentes, MD, MS, Seattle Children’s Research Institute, 2001 Eighth Ave, Suite 624, Seattle, WA 98121. E-mail: molly.fuentes{at}seattlechildrens.org