Nearly Half of Adolescents Lack a Patient-Centered Medical Home

“There’s a big problem with trying to coordinate mental health care and the system is failing families. If mental health is addressed early, it can lessen the impact, so it’s important to be proactive.” 

UCSF researchers conducted the first study ever to comprehensively examine medical homes for adolescents. They reviewed the rates of medical home attainment from the 2007 National Survey of Children’s’ Health (NSCH), a national survey of 91,642 parents, including roughly 45,000 who had children aged 10 to 17.

The researchers then analyzed the past-year medical home rates, whether they varied by age, and whether or not the medical home status was related to an adolescents’ mental health status. They also looked at whether the adolescents were given referrals when necessary.

The researchers found that 46 percent of adolescents lacked a past-year medical home, with lower rates for lower-income, minority and uninsured youth. Adolescents with depression, anxiety, ADHD, learning disabilities, developmental delays are autism diagnoses all had lower medical home rates than those without mental health conditions.  

Medical home rates for Hispanic (33 percent) and black (42 percent) adolescents were significantly lower than rates for white (64 percent) adolescents. Those from non-English speaking households were less likely to have a medical home, receive family centered care and referrals when necessary.  

The study, “Medical home for adolescents: low attainment rates for those with mental health problems and other vulnerable groups,” was published in the March-April issue of Academic Pediatrics.

The study provides an important national baseline for the proportion of adolescents receiving care in a medical home, and can be used to measure progress.

The next phase of research will involve analyzing data from the recently released 2011 NSCH which will provide an initial evaluation of changes in medical home status following initiation of the Affordable Care Act.

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