(Press-News.org) Ann Arbor, Mich. — Primary care practices around the country are being encouraged and even paid to become "medical homes," but small practices might be at a significant disadvantage in this race to improve health care for children, according to a new study by child health experts at C.S. Mott Children's Hospital.
Efforts around the country to improve health care for children have increasingly focused on the medical home as a model to make primary care practices more accessible, comprehensive, and focused on quality improvement. Since 2008, practices could become officially recognized as a medical home by documenting that they meet specific criteria. Hundreds of primary care practices around the country have sought or are seeking recognition as medical homes.
The new study, published in this month's Pediatrics, shows that pediatric and family medicine practices that serve children, especially those with five or fewer physicians, are relatively unprepared to become recognized as medical homes.
"Getting recognized as a medical home is often the first step for practices to participate in programs that are trying to improve primary care for children. These practices can be at a serious disadvantage," says U-M pediatrician Joe Zickafoose, M.D., M.S., formerly a research fellow with the Child Health Evaluation and Research Unit at the University of Michigan C.S. Mott Children's Hospital and now a health researcher with Mathematica Policy Research.
Recent studies have shown that small primary care practices for adults are at a disadvantage for becoming medical homes, but no large studies have looked at practices for children.
The majority of primary care for children still occurs in small practices with five or fewer physicians. These practices may be less likely to have the additional resources needed to become recognized as medical homes and miss out on the additional resources and financial support that often comes with participation in medical home programs.
Data used in the study came from the National Ambulatory Medical Care Survey, which is an annual sample of outpatient visits to randomly selected, non–federally employed, office-based physicians in the United States. When the survey is conducted, participating physicians are asked about characteristics of their practice.
The investigators examined data from the 2007 & 2008 rounds of the survey. They connected practice characteristics asked about in the survey to the National Committee for Quality Assurance's (NCQA) Patient-Centered Medical Home standards, the most commonly used medical home recognition process around the U.S.
The investigators found that on average pediatrics and family medicine practices only met 38% of the NCQA medical home standards that could be measured in the survey. Smaller primary care practices scored 10 to 14 points lower on a 100-point scale when compared to medium and large practices.
The authors were originally concerned that practices might be at a disadvantage for becoming a medical home if they served larger numbers of children in public health insurance programs, who on average have higher medical needs, but they found no differences based on this or other characteristics of the practices.
"We hope that our study helps reinforce the importance of providing additional supports to small primary care practices in efforts to improve health care for children ," says Zickafoose, lead author of the study.
INFORMATION:
Additional authors: Sarah J. Clark, MPH, Joseph W. Sakshaug, PhD, Lena M. Chen, MD, MSc, John M. Hollingsworth, MD, MS
Disclosures: None
Citation: Zickafoose JS, Clark SJ, Sakshaug JW, Chen LM, Hollingsworth JM. Readiness of primary care practices for medical home certification. Pediatrics. 2013. 131:3;473-482.
About the Child Health Evaluation and Research Unit (CHEAR):
Founded in 1998, U-M's CHEAR Unit is a national leader in the analysis of the American health care system and the organization and financing of care for children. Since its inception, the CHEAR Unit has been awarded over $40 million in research grants from federal, state, and foundation sources. The CHEAR Unit comprises core faculty from the Schools of Medicine, Social Work, Dentistry, Pharmacy, Nursing, Public Health, Business and Law. Multidisciplinary teams provide the structure for research of community, state and national child health policies, practices, and programs. There are more than 30 faculty affiliated with CHEAR.
About C.S. Mott Children's Hospital in the University of Michigan Health System:
Since 1903, the University of Michigan has led the way in providing comprehensive, specialized health care for children. From leading-edge heart surgery that's performed in the womb to complete emergency care that's there when you need it, families from all over come to the University of Michigan C.S. Mott Children's Hospital for our pediatric expertise. In 2013, C.S. Mott Children's Hospital was ranked eighth in the nation in Parents Magazine's 10 Best Children's Hospitals ranking. To learn more, go to http://www.mottchildren.org.
END
What can green algae do for science if they weren't, well, green?
That's the question biologists at UC San Diego sought to answer when they engineered a green alga used commonly in laboratories, Chlamydomonas reinhardtii, into a rainbow of different colors by producing six different colored fluorescent proteins in the algae cells.
While fluorescent green, red, blue and yellow may be all the rage this year for running shoes and other kinds of sporting gear, fluorescent algae hasn't been a style trend yet in scientific laboratories. But in announcing their achievement in ...
WACO, Texas (March 7, 2013) - A genetic analysis by Baylor University biologists suggests that the stocking of Florida bass in Texas reservoirs impacts bass populations far beyond the actual stocking location.
The native largemouth bass has a long and nearly continuous stocking history in Texas. However, the Florida bass is widely considered a better sport fish because it grows to a greater size. Subsequently, stocking efforts in Texas reservoirs have transitioned from largemouth bass to Florida bass.
The Baylor researchers analyzed the genetic composition of 69 largemouth ...
Malaria, the leading cause of death among children in Africa, could be eliminated if three-fourths of the population used insecticide-treated bed nets, according to a new study from the National Institute for Mathematical and Biological Synthesis (NIMBioS).
The study, which uses a mathematical model, found that use of insecticide-treated bed nets or ITNs positively affected the infection's reproduction number, or R, which is the primary epidemiological number used to determine the degree which a disease can spread through a population. The model concludes that if 75 percent ...
VIDEO:
This animation of NOAA GOES-13 satellite imagery from March 5-7, 2013, shows the progression of a cold front from the west associated with a low pressure system that brought snow...
Click here for more information.
The merging of two low pressure areas into a large Nor'easter on March 6 brought winter weather advisories and warnings to the Mid-Atlantic. NASA's Aqua satellite captured an infrared and near infrared image of the storm's power, and NASA created an animation ...
The star Eta Carinae is ready to blow. 170 years ago, this 100-solar-mass object belched out several suns' worth of gas in an eruption that made it the second-brightest star after Sirius. That was just a precursor to the main event, since it will eventually go supernova.
Supernova explosions of massive stars are common in spiral galaxies like the Milky Way, where new stars are forming all the time. They are almost never seen in elliptical galaxies where star formation has nearly ceased. As a result, astronomers were surprised to find a young-looking supernova in an old ...
With data from 73 ice and sediment core monitoring sites around the world, scientists have reconstructed Earth's temperature history back to the end of the last Ice Age.
The analysis reveals that the planet today is warmer than it's been during 70 to 80 percent of the last 11,300 years.
Results of the study, by researchers at Oregon State University (OSU) and Harvard University, are published this week in a paper in the journal Science.
Lead paper author Shaun Marcott of OSU says that previous research on past global temperature change has largely focused on the ...
HOUSTON – (March 7, 2013) – Results of a study using several imaging methods showed that CCSVI (chronic cerebrospinal venous insufficiency) occurs at a low rate in both people with multiple sclerosis (MS) and non-MS volunteers, contrary to some previous studies. The research by an interdisciplinary team at The University of Texas Health Science Center at Houston (UTHealth) was published in a recent early online edition of the Annals of Neurology.
"Our results in this phase of the study suggest that findings in the major veins that drain the brain consistent with CCSVI ...
A new report from the Wildlife Conservation Society Canada (WCS Canada) creates a conservation strategy that will promote wildlife resiliency in the Southern Canadian Rockies to the future impacts of climate change and road use. The report's "safe passages and safe havens" were informed in part by an assessment of six iconic species—bull trout, westslope cutthroat trout, grizzly bears, wolverines, mountain goats and bighorn sheep—five of which were ranked as highly vulnerable to projected changes.
Nestled between Glacier National Park in Montana and Banff National ...
In the movie Alien, the title character is an extraterrestrial creature that can survive brutal heat and resist the effects of toxins.
In real life, organisms with similar traits exist, such as the "extremophile" red alga Galdieria sulphuraria.
In hot springs in Yellowstone National Park, Galdieria uses energy from the sun to produce sugars through photosynthesis.
In the darkness of old mineshafts in drainage as caustic as battery acid, it feeds on bacteria and survives high concentrations of arsenic and heavy metals.
How has a one-celled alga acquired such ...
Scientists at UC San Francisco have found a more precise way to turn off genes, a finding that will speed research discoveries and biotech advances and may eventually prove useful in reprogramming cells to regenerate organs and tissues.
The strategy borrows from the molecular toolbox of bacteria, using a protein employed by microbes to fight off viruses, according to the researchers, who describe the technique in the current issue of Cell.
Turning off genes is a major goal of treatments that target cancer and other diseases. In addition, the ability to turn genes off ...
