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Increase the proportion of children and adolescents who receive care in a medical home — MICH‑19 Data Methodology and Measurement

About the National Data

Data

Baseline: 48.6 percent of children and adolescents under 18 years received care in a medical home in 2016-17

Target: 53.6 percent

Numerator
Number of children and adolescents under 18 years receiving care in medical homes.
Denominator
Number of children and adolescents under 18 years.
Target-setting method
Percentage point improvement
Target-setting method details
Percentage point improvement from the baseline using Cohen's h effect size of 0.10.
1
Target-setting method justification
Trend data were not available for this objective. A percentage point improvement was calculated using Cohen's h effect size of 0.1. This method was used because it was a statistically significant improvement from the baseline.

Methodology

Questions used to obtain the national baseline data

(For additional information, please visit the data source page linked above.)

From the 2016 through 2017 National Survey of Children's Health:

Numerator:
Is there a place that this child USUALLY goes when he or she is sick or you or another caregiver needs advice about his or her health?
  1. Yes
  2. No
Where does this child USUALLY go? Mark ONE only.
  1. Doctor's Office
  2. Hospital Emergency Room
  3. Hospital Outpatient Department
  4. Clinic or Health Center
  5. Retail Store Clinic or "Minute Clinic"
  6. School (Nurse's Office, Athletic Trainer's Office)
  7. Some other place
Do you have one or more persons you think of as this child's personal doctor or nurse? A personal doctor or nurse is a
health professional who knows this child well and is familiar with this child's health history. This can be a general doctor, a
pediatrician, a specialist doctor, a nurse practitioner, or a physician's assistant.
  1. Yes, one person
  2. Yes, more than one person
  3. No
DURING THE PAST 12 MONTHS, did this child need a referral to see any doctors or receive any services?
  1. Yes
  2. No
How much of a problem was it to get referrals?
  1. Not a problem
  2. Small problem
  3. Big problem
Does anyone help you arrange or coordinate this child's care among the different doctors or services that this child uses?
  1. Yes
  2. No
  3. Did not see more than one health care provider in past 12 months
Overall, how satisfied are you with the communication among this child's doctors and other health care providers?
  1. Very Satisfied
  2. Somewhat satisfied
  3. Somewhat dissatisfied
  4. Very dissatisfied
DURING THE PAST 12 MONTHS, did this child's health care provider communicate with this child's school, child care provider, or special education program?
  1. Yes
  2. No
  3. Did not need health care provider to communicate with these providers
DURING THE PAST 12 MONTHS, how often did this child's doctors or other health care providers: Spend enough time with this child?
  1. Always
  2. Usually
  3. Sometimes
  4. Never

Methodology notes

The measurement of medical home access in the 2016 National Survey of Children's Health has been described in detail elsewhere. In brief, the overall medical home measure from the 2016 NSCH is a composite of five sub-component topics assessing whether the child had/received the following based on parent/caregiver report: had a usual doctor or nurse, had a usual source of sick care (other than the emergency room); received needed referrals, received needed care coordination, and received family-centered care.

History

Comparable HP2020 objective
Modified, which includes core objectives that are continuing from Healthy People 2020 but underwent a change in measurement.
Changes between HP2020 and HP2030
This objective differs from Healthy People 2020 objective MICH-30.1 in that objective MICH-30.1 tracked children and adolescents who have access to a medical home, while this objective tracks children and adolescents who receive care in a medical home. The wording change resulted from revisions in the data source.

1. Effect size h=0.1 was chosen to correspond with 10% improvement from a baseline of 50%.