Healthcare Utilization and Transitions for Adolescents with Special Health Care Needs

Nearly twenty percent of adolescents have health consequences attributable to persistent medical, behavioral, or other health conditions, and the number of adolescents with special health care needs (ASHCN) that survive into adulthood continues to increase. There is evidence that the patient-centered medical home (PCMH) health care delivery model provides children more effective, efficient, and timely care at lower cost, particularly among the highest utilizers: children with special health care needs. The hypotheses are that ASHCN in PCMH will have more primary care visits, fewer emergency room visits, fewer inpatient stays, and fewer hospital readmissions within 30 days and will be more likely to successfully transition to adult providers than ASHCN not in PCMH. The two studies proposed to test these hypotheses are designed to (1) measure the impact of PCMH recognition on health care service utilization among ASHCN by level of medical complexity and (2) assess the successful transition of ASHCN from a pediatric PCMH to an adult provider by ASHCN level of medical complexity.