The impact of the medical home on access to care for children with autism spectrum disorders.
A medical home slices unmet specialty-care needs for kids with autism, but Latino and rural families still need extra help to see the same gain.
01Research in Context
What this study did
Schaaf et al. (2015) asked if a medical home helps kids with autism get specialty care. A medical home means one doctor team knows the child and plans all care.
They looked at families who used this model and compared unmet needs with families who did not.
What they found
Kids with autism in a medical home had one-third fewer unmet specialty-care needs. Fewer families said, 'We still can't see the doctor we need.'
How this fits with other research
Takahashi et al. (2023) later found even bigger gains: an 86% drop in unmet mental-health needs for autistic teens. Their larger, newer numbers update and strengthen the 2015 result.
A Boyd et al. (2024) seems to disagree. They saw that high care-coordination scores can lower the odds of early autism spotting in babies. The key difference is age: babies need fast diagnosis, while school-age kids need steady access. Timing changes what 'good coordination' looks like.
Byers et al. (2013) and Zhang et al. (2017) show the medical-home boost may not reach everyone. Latino and rural families still report later diagnosis and more ER trips. Schaaf et al. (2015) captured the average gain; these studies remind us equity gaps remain.
Why it matters
You can tell funders and pediatricians that a medical home is worth the effort. It already cuts unmet needs by one-third, and newer data say the payoff can be even larger for teens. Push for the model, but add extra supports for Latino and rural families so the benefit spreads to every child on your caseload.
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02At a glance
03Original abstract
Children with autism spectrum disorders (ASD) experience difficulty accessing health care services. Using parent-reported data from the 2009-2010 National Survey of Children with Special Health Care Needs, we examined whether having a medical home reduces unmet need for specialty care services for children with ASD (n = 3,055). Descriptive statistics and Chi square tests identified sample characteristics and examined the relationship between unmet needs and a standardized measure of medical home. Logistic regression models explored the individual impact of demographic, condition-specific and medical home variables on unmet need. Parents reported that nearly all children had a need for specialty services, 36 % had an unmet need, and 23.9 % had a medical home. Children who had fewer unmet needs were more likely to have received family-centered and coordinated care through a medical home, and this relationship remained significant even when demographic and condition-specific variables were taken into account. These findings suggest ways to improve access to care for children with ASD through enhanced family-centered and coordinated care within the medical home.
Journal of autism and developmental disorders, 2015 · doi:10.1007/s10803-014-2218-3