Vol.:(0123456789) 1 3
Maternal and Child Health Journal (2018) 22:1451–1461
https://doi.org/10.1007/s10995-018-2540-z
Patient-Centered Medical Home and Receipt of Part C Early
Intervention Among Young CSHCN and Developmental Disabilities
Versus Delays: NS-CSHCN 2009–2010
Samantha M. Ross
1
· Ellen Smit
2
· Erica Twardzik
3
· Samuel W. Logan
4
· Beth M. McManus
5
Published online: 5 June 2018
© Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract
Objective To determine, among a sample of young CSHCN with developmental conditions, (1) characteristics associated
with receipt of both patient-centered medical home (PCMH) and Part C early intervention, (2) the association between each
PCMH criterion and receipt of Part C generally, and (3) for CSHCN with disabilities versus delays. Methods Secondary data
analysis of the 2009/10 National Survey of CSHCN. Sample included CSHCN (n = 755) birth to 3 years with a developmen-
tal disability or delay that afected their function. Adjusted ordinal regression analysis examined characteristics associated
with receiving both PCMH and Part C. Stratifed adjusted logistic regression examined the association between PCMH
criteria and Part C, by disabilities versus delays. Results 19% of our sample received both PCMH and Part C. Black, non-
Hispanic children had lower odds [OR 0.44, 95% CI (0.20, 0.97)] and CSHCN with more severe developmental conditions
had higher odds [OR 2.13, 95% CI (1.22, 3.17)] of receiving both services. CSHCN with a PCMH were no more likely to
be receiving Part C than those without a PCMH [OR 0.85, 95% CI (0.49, 1.49)]. Receiving any one of the PCMH criterion
was not associated with receiving Part C, with one exception. Among CSHCN with delays, efective care coordination was
associated with lower odds of Part C [OR 0.46, 95% CI (0.21, 0.97)]. Conclusion Concurrent PCMH and Part C access was
low for young CSHCN with developmental conditions afecting their function. Given the overlapping mandates for PCMH
and Part C, integrated eforts are warranted to identify if lack of concurrent services in fact refects unmet service needs.
Keywords Patient-centered medical home · Early intervention · Children with special health care needs · Developmental
screening · Health care utilization · Service access
* Samantha M. Ross
Samantha.Ross@oregonstate.edu
Ellen Smit
Ellen.Smit@oregonstate.edu
Erica Twardzik
etwardzi@umich.edu
Samuel W. Logan
Sam.Logan@oregonstate.edu
Beth M. McManus
beth.mcmanus@ucdenver.edu
1
Kinesiology, Adapted Physical Activity, College of Public
Health and Human Sciences, Oregon State University,
Women’s Building 08b 160 SW 26th Street, Corvallis,
OR 97331, USA
2
Public Health, Epidemiology School of Biological
and Population Health Sciences, College of Public Health
and Human Sciences, Oregon State University, Milam 135,
Corvallis, OR 97331, USA
3
School of Kinesiology, School of Public Health,
Epidemiology, University of Michigan, 1402 Washington
Heights, Ann Arbor, MI 48109-2013, USA
4
Kinesiology, Adapted Physical Activity, College of Public
Health and Human Sciences, Oregon State University,
Women’s Building 203B, Corvallis, OR 97331, USA
5
Children’s Outcomes Research Group, Department of Health
Systems, Management and Policy, Colorado School of Public
Health, 13001 E. 17th Place, MS B119, Aurora, CO 80045,
USA