地域医療と健康教育

抽象的な

Factors Associated with a Patient Centered Medical Home among Obese and Overweight Children

Caprice Knapp, Shannon Alford and Reva Ranka

Objective: This study aims to determine the frequency of overweight and obese children that have a Patient Centered Medical Home (PCMH), the factors associated, and the effect of having one on several common child outcomes. Methods: 43,501 children from the 2011-2012 National Survey of Children’s Health were analysed for this study. Descriptive, bivariate, and multivariate analyses were conducted. Results: Parents report that 54% of overweight and obese children have a patient centered medical home. Results from the multivariate models suggest that just being overweight and obese was not associated with having a medical home. However, when comorbidities were accounted for overweight and obese children were less likely to have a medical home and had decreased outcomes as compared to their underweight/healthy weight peers. Obese and overweight children with comorbidities were more likely to have a personal doctor but less likely to have effective care coordination. Conclusions: The PCMH is a model that could be used to improve health and health outcomes for the most vulnerable children. However, obesity should be taken as a chronic condition just as other conditions and addressed on a routine bases. The PCMH model offers a vehicle to develop and implement population-based processes to identify, assess, and manage care for these children.