By Dennis Thompson HealthDay Reporter
WEDNESDAY, Dec. 24, 2014 (HealthDay News) -- Very sick children with complex chronic illnesses can receive effective, less expensive care from a clinic that functions as a "medical home," with easy access to a team of dedicated health care professionals, a new study shows.
Children were less likely to become seriously ill and need either hospitalization or a trip to the emergency room when they received treatment at an enhanced medical home clinic at the University of Texas in Houston versus usual care, according to a report published in the Dec. 24/31 issue of the Journal of the American Medical Association.
"These are very complex children at high risk, and we don't wait until they're really sick for them to get treatment," said study author Dr. Ricardo Mosquera, an assistant professor of pediatrics at the University of Texas Medical School. "We save money because these patients are not often in the hospital," he added.
The patient-centered medical home is a concept that has become more popular with the advent of health-care reform. In a medical home, each person has a primary care physician who oversees their medical care, coordinating with specialists and any other health care workers that might be needed to keep them healthy.
This new study focused on an enhanced version of the medical home concept, Mosquera said, in which children with severe chronic illnesses were enrolled in intense coordinated care through the University of Texas, Houston, High-Risk Children's Clinic.
The researchers felt that medical homes' greatest potential might be in the treatment of patients with severe chronic illness, given that their care often is piecemeal, expensive and unlikely to prevent future illness.
Mosquera and his colleagues randomly assigned 105 high-risk children with chronic illness to receive comprehensive care, including treatment from primary care doctors and specialists in the same clinic. Another 96 high-risk children received regular care from doctors or clinics.
Patients were defined as high-risk with chronic illness if they had three or more emergency department visits, two or more hospitalizations, or one or more pediatric intensive care unit admissions during the previous year, and a greater than 50 percent estimated risk for hospitalization, the researchers said.
The children most often suffered from multiple illnesses, including respiratory and neurological disorders, Mosquera said.
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Coordinated Care Through 'Medical Home' Best for Chronically Ill Kids: Study