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Maternal and child health journal
Aug, 2021;25 (8): 1285-1295.

The Effect of Medical Home on Shared Decision-Making for Caregivers of Children with Emotional, Developmental, or Behavioral Health Conditions.

Mckenzee Chiam, Erick Rojas, Meredith R Bergey, Thomas I Mackie
Author Information
  1. Mckenzee Chiam: Penn State College of Medicine, Hershey, PA, 17033, USA.
  2. Erick Rojas: Institute for Health, Health Care Policy and Aging Research, Rutgers, the State University of New Jersey, 112 Paterson St, New Brunswick, NJ, 08901, USA.
  3. Meredith R Bergey: Department of Sociology and Criminology, Villanova University, 800 Lancaster Ave., Villanova, PA, 19085, USA.
  4. Thomas I Mackie: Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, 683 Hoes Lane, Piscataway, NJ, 08854, USA. tmackie@ifh.rutgers.edu.
PMID: 33942231 DOI: 10.1007/s10995-021-03148-w

Abstract

INTRODUCTION: Known as the "pinnacle of patient-centered care," shared decision-making (SDM) is the process that enables and encourages the health care provider, the patient, and/or their caregiver (parent or guardian) to participate collaboratively in medical decisions. Prior research indicates that children with emotional, developmental, or behavioral health conditions (EDB) are less likely to attain SDM than children with other special health care needs (SHCNs). This study investigates whether the presence of a medical home reduces disparities in SDM among children with EDB when compared to children with other SHCNs and the general pediatric population.
METHODS: Using the 2016 National Survey of Children's Health, we conducted weighted descriptive statistics to investigate the prevalence of medical home and SDM for children with (1) EDB, (2) other SHCNs, and (3) no SHCNs. We then employed a nested multivariate logistic regression model to examine whether the presence of a medical home reduced the disparity between children with EDB and their counterparts.
RESULTS: Nationally, 21% of children with EDB (n = 647,274), 14.0% of children with other SHCNs (n = 1,086,068), and 13% of children with no SHCNs (n = 883,969) did not attain caregiver-reported SDM in medical care. In each of the health condition groups, the presence of a medical home significantly improved the odds of SDM (p < 0.001). Presence of a medical home also reduced the disparities observed in caregiver-reported SDM among children with EDB as compared to those with other SHCNs and no SHCNs.
DISCUSSION: Ongoing investment in medical homes may reduce disparities in SDM experienced by children with EDB.

Keywords

Children with special health care needs Medical home National Survey of Children’s Health Shared decision-making

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Grants

  1. 1460354/National Science Foundation

MeSH Term

Caregivers
Child
Decision Making
Disabled Children
Humans
Parents
Patient-Centered Care
Journal Article

Word Cloud

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