Date of Graduation

5-2015

Document Type

Thesis

Degree Name

Bachelor of Science in Nursing

Degree Level

Undergraduate

Department

Nursing

Advisor/Mentor

Jean-Louis, Marie-Rachelle

Committee Member/Reader

Smith-Blair, Nancy J.

Committee Member/Second Reader

Henderson, Jaye

Abstract

A growing number of children are being diagnosed with attention deficit disorder and hyperactivity (ADD/ADHD) and autism in Arkansas. These developmental disorders necessitate comprehensive, holistic, effective and well-coordinated care, and require a complex treatment regimen. Lack of access to coordinated care creates a real impediment for these children as they are in constant need for medical services. Pediatric care provided within a medical home has been suggested to improve health outcomes of children with special health care needs. OBJECTIVE: The purpose of this study was to determine access to a medical home among children aged 6-17 years with ADD/ADHD, autism, and with both disorders in Arkansas. METHODS: We used the National Survey of Children with Special Health Care Needs (2009-2010) to describe medical home among children with ADD/ADHD, with autism, and with both disorders as reported by their families. We conducted bivariate analyses to study access to a medical home based on race/ethnicity, education, insurance type, family structure and poverty status. Multivariate logistic regressions were used to ascertain the odds for these children of having a medical home. RESULTS: 43,249 children had ADD/ADHD, 3,338 had autism, and 5,205 had both ADD/ADHD and autism in Arkansas. As compared to parents of children with ADD/ADHD, parents of children with ADD/ADHD and autism were less likely to report having a medical home. These parents were less likely to state that their child had received a family-centered care; they were less likely to report that their child had received effective care coordination; they were less likely to mention that they had received help to coordinate their child’s health care when needed, and they were less likely to report being very satisfied with communication among their child’s doctors. No statistical differences were found in access to a medical home between children with ADD/ADHD vs. autism. CONCLUSION: Children with developmental disorders such as ADD/ADHD and autism have multiple and complex health care needs. They need accessible, coordinated and family-centered care. The coexistence of these two conditions renders access to a medical home even more challenging for these children who need it the most. More efforts should be made by health care providers and policy-makers to expand access to medical home to children with ADD/ADHD, autism, and to those with both of these conditions.

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