Medical care research and review : MCRR
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This study examined data from the 2005-2006 National Survey of Children with Special Health Care Needs to assess the relationship among children with asthma between a reported medical home and emergency department (ED) use. The authors used 21 questions to measure 6 medical home components: personal doctor/nurse, family-centered, compassionate, culturally effective and comprehensive care, and effective care coordination. ⋯ Receiving primary care in a medical home was associated with fewer ED visits (incidence rate ratio = 0.93; 95% confidence interval = 0.89-0.97). A medical home in which physicians and parents share responsibility for ensuring that children have access to needed services may improve child and family outcomes for children with asthma.
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This study examines the consequences for medical specialists of participating in multidisciplinary medical team meetings in terms of perceived clinical autonomy, domain distinctiveness, and professional accountability. These consequences may influence their willingness to cooperate and the quality of teamwork. ⋯ However, a few specific specialties had response patterns that deviated from our expectations. The results are related to specialty choice, to the training of medical specialties, and to having a role in leading team meetings.
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A growing literature finds that a significant fraction of American families experience high or "catastrophic" burdens of medical spending. Families facing mental health problems may be especially vulnerable to high burdens. This study uses data from the Medical Expenditure Panel Survey to determine the annual and within-year concentration of medical spending and the extent to which mental health treatment contributes to high out-of-pocket burdens among families with and without mental health problems. ⋯ Families with one or more members experiencing mental health problems were more likely to have periods of high out-of-pocket spending burdens. However, this study found that mental health treatment itself contributes little to high out-of-pocket spending burdens. Most of the burden was due to other medical conditions and lower average incomes among families with mental health problems.