Evaluation of a statewide medical home program on children and young adults with asthma

J Asthma. 2015;52(9):940-8. doi: 10.3109/02770903.2014.999282. Epub 2015 Aug 25.


Objective: Asthma, the most common chronic condition among children, accounts for significant healthcare utilization and impact on quality of life. Care coordination in a medical home is considered standard practice, but has not been rigorously evaluated.

Methods: We initiated this pilot study of children/young adults with asthma (n = 967), ages: birth to 24 years, receiving care from a subset of pediatric practices (n = 20) participating in the Pennsylvania Medical Home Initiative, Educating Practices in Community-Integrated Care (92 practices statewide). We hypothesized children and youth with asthma receiving care coordination in the context of a formal medical home program would experience favorable associations with healthcare utilization and quality of life measures.

Results: A total of 9240 care coordination encounters for this cohort of children/youth occurred over 100 days. The average length of care coordination encounter was 20.7 minutes. The most common care coordination activity was referral management (21%) and the care coordinator in the practice most often contacted parent/family and specialists (75%). Children with more severe asthma had more hospitalizations and emergency department (ED) visits than children with less severe asthma. There was a significant decrease in school absences, ED visits and acute care visits for children/youth with asthma with increasing length of time in a medical home program (p < 0.05).

Conclusion: Care coordination for children/youth with asthma is feasible and may yield improvements in healthcare utilization, expenditures and quality of life. Larger-scale implementation of care coordination and medical home models for children/youth with asthma and other diagnoses are warranted.

Keywords: Asthma; care coordination; children and youth with special healthcare needs; healthcare utilization; medical home; young adults.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Asthma / therapy*
  • Child
  • Child, Preschool
  • Disease Management*
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Health Services / statistics & numerical data
  • Hospitalization / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Interpersonal Relations
  • Male
  • Patient Care Team
  • Patient-Centered Care / organization & administration*
  • Pilot Projects
  • Quality of Life*
  • Severity of Illness Index
  • Time Factors