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Measure of Medical Home for Children and Adolescents

CBE ID
0724
1.4 Project
Health and Well Being
Endorsed
Endorsement Status
Endorsement Removed
1.1 New or Maintenance
Maintenance
E&M Cycle
Full Year 2015
Is Under Review
No
1.3 Measure Description

This composite measure assesses whether or not children and adolescents (age 0-17 years) receive health care within a medical home according to the survey respondent (almost always the child’s parent). The medical home measure is based on six of the seven components of care first proposed by the American Academy of Pediatrics (AAP)—health care that is accessible, family-centered, continuous, comprehensive, coordinated, compassionate, and culturally effective. (Note: "accessible" is the one component of medical home that is not directly addressed in this composite measure. This will be explained in a later section)

The AAP policy statement emphasizes that a medical home is “not a building, house, or hospital, but rather an approach to providing continuous and comprehensive primary pediatric care from infancy through young adulthood, with availability 24 hours a day, 7 days a week, from a pediatrician or physician whom families trust,” and this composite measure of medical home is designed to assess the receipt of quality health care using the AAP´s recommended care guidelines.

    • 1.14 Numerator

      The Measure of Medical Home for Children Adolescents measures whether or not a child or adolescent is receiving care within a medical home--that is, care that meets all of the following criteria--child has a regular doctor or nurse AND has a usual place for well and sick care AND receives care that is family-centered AND has no problems getting referrals when needed AND receives effective care coordination when needed.

    • 1.15 Denominator

      Main denominator: Children age 0-17 years in the U.S. (this measure has only been officially tested on children in the United States and has not been tested for potential cultural differences among other countries).

      Domain-Specific denominators:
      • Established relationship with a specific provider:
      o Children age 0-17 years in the U.S.
      • Family-centered/Compassionate:
      o Children age 0-17 years in the U.S. who received at least 1 service from a doctor or other health care provider in the past 12 months
      • Comprehensive:
      o Children age 0-17 years in the U.S.
      • Coordinated:
      o K5Q31, K5Q32 : Children age 0-17 years in the U.S. who received at least 1 service from a doctor or other health care provider in the past 12 months
      o K5Q20, K5Q21, K5Q22, and K5Q30: Children age 0-17 years in the U.S. who received 2 or more services from a doctor or other health care provider in the past 12 months
      • Culturally effective:
      o K5Q42: Children age 0-17 years in the U.S. who received at least 1 service from a doctor or other health care provider in the past 12 months
      o K5Q45 and K5Q46: Children age 0-17 years in the U.S. who speak a primary household language other than English or unknown

    • Exclusions

      The minimum denominator exclusions are: if the child is not between the ages of 0 and 17 years, if the child does not have at least 1 healthcare provider considered to be a personal doctor or nurse, or if the child does not have a usual source for both sick and well-child care, or if the child has not used any health-related services in the past 12 months. More specific denominator exclusions are explained in 2a.4. and 2a.10.

    • Most Recent Endorsement Activity
      Measure Retired and Endorsement Removed Health and Well Being Project 2015-2017
      Initial Endorsement
      Last Updated
      Removal Date