TUESDAY, Dec. 23, 2014 (HealthDay News) -- For high-risk children with chronic illness, an enhanced medical home providing comprehensive care is associated with reductions in serious illnesses and costs, according to a study published in the Dec. 24/31 issue of the Journal of the American Medical Association.
Ricardo A. Mosquera, M.D., from the University of Texas Medical School in Houston, and colleagues conducted a randomized trial involving high-risk children with chronic illness to examine the role of an enhanced medical home providing comprehensive care. Overall, 105 participants were randomized to comprehensive care and 96 to usual care.
The researchers found that comprehensive care correlated with reductions in the rate of children with a serious illness (10 versus 22 per 100 child-years; rate ratio, 0.45) and in total hospital and clinic costs ($16,523 versus $26,781 per child-year; cost ratio, 0.58). There was a probability of 97 percent that comprehensive care was cost neutral or cost saving. Comprehensive care correlated with reductions in serious illnesses, emergency department visits, hospitalizations, pediatric intensive care unit admissions, and number of days in a hospital. Furthermore, there were reductions in Medicaid payments (by $6,243 per child-year) and increases in medical school losses ($6,018 per child-year).
"These findings from a single site of selected patients with a limited number of clinicians require study in larger, broader populations before conclusions about generalizability to other settings can be reached," the authors write.
One author disclosed receiving personal fees from Clifton Health.
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