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American Academy of Pediatrics
Article

Does Connection to Primary Care Matter for Children With Attention-Deficit/Hyperactivity Disorder?

Sara L. Toomey, Jonathan Finkelstein and Karen Kuhlthau
Pediatrics August 2008, 122 (2) 368-374; DOI: https://doi.org/10.1542/peds.2007-2794
Sara L. Toomey
aHarvard-wide Pediatric Health Services Research Fellowship, Boston, Massachusetts
bDepartment of Ambulatory Care and Prevention and Harvard Medical School, Boston, Massachusetts
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Jonathan Finkelstein
bDepartment of Ambulatory Care and Prevention and Harvard Medical School, Boston, Massachusetts
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Karen Kuhlthau
cCenter for Child and Adolescent Health Policy, Massachusetts General Hospital for Children, Boston, Massachusetts
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Abstract

OBJECTIVE. Whether high-quality primary care in the form of a medical home effectively meets the health care needs of children with attention-deficit/hyperactivity disorder is unknown. The objectives of this study were to (1) describe the percentage who report unmet health care need, (2) evaluate whether having a medical home is associated with lower risk for having unmet needs, and (3) compare the impact of having a medical home on unmet need for children with attention-deficit/hyperactivity disorder with those with asthma.

METHODS. Cross-sectional analysis was conducted of the National Survey of Children's Health, 2003, a nationally representative sample. The primary outcome variable was parent-reported unmet health care need. Multivariate logistic regression tested the impact of having a medical home on unmet needs for children with attention-deficit/hyperactivity disorder and asthma.

RESULTS. The National Survey of Children's Health interviewed parents of 6030 children who had attention-deficit/hyperactivity disorder and 6133 children who had asthma and were between the ages of 6 and 17 years. A total of 16.8% of children with attention-deficit/hyperactivity disorder had at least 1 unmet need compared with 6.7% of children with asthma. Although the proportion of children with a medical home was comparable, children with attention-deficit/hyperactivity disorder were 3.5 times more likely to have an unmet need than were children with asthma. Children with asthma who have a medical home have less than half the likelihood of reporting an unmet need in comparison with those without a medical home; however, among children with attention-deficit/hyperactivity disorder, having a medical home was not associated with decreased likelihood of reporting an unmet need.

CONCLUSIONS. Having a medical home is not associated with fewer unmet needs for children with attention-deficit/hyperactivity disorder. Our results suggest that high-quality primary care may not be as successful at meeting the needs of children with behavioral health conditions compared with those with physical conditions.

  • ADHD
  • unmet needs
  • primary care
  • medical home
  • Accepted November 15, 2007.
  • Copyright © 2008 by the American Academy of Pediatrics

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Pediatrics
Vol. 122, Issue 2
August 2008
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Does Connection to Primary Care Matter for Children With Attention-Deficit/Hyperactivity Disorder?
Sara L. Toomey, Jonathan Finkelstein, Karen Kuhlthau
Pediatrics Aug 2008, 122 (2) 368-374; DOI: 10.1542/peds.2007-2794

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Does Connection to Primary Care Matter for Children With Attention-Deficit/Hyperactivity Disorder?
Sara L. Toomey, Jonathan Finkelstein, Karen Kuhlthau
Pediatrics Aug 2008, 122 (2) 368-374; DOI: 10.1542/peds.2007-2794
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Subjects

  • Developmental/Behavioral Pediatrics
    • Developmental/Behavioral Pediatrics
    • Attention-Deficit/Hyperactivity Disorder (ADHD)

Keywords

  • ADHD
  • unmet needs
  • primary care
  • medical home
  • ADHD—attention-deficit/hyperactivity disorder
  • CSHCN—children with special health care needs
  • PCP—primary care provider
  • AAP—American Academy of Pediatrics
  • NSCH—National Survey of Children's Health, 2003
  • OR—odds ratio
  • CI—confidence interval
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