A medical home was defined in the report as a doctor's office offering easily accessible, coordinated care that caters to the family. The concept has gained popularity in recent years as a way to streamline the often complex medical situations for people with chronic illnesses.

In the latest study, researchers found children with a medical homemade fewer trips to the emergency department and had fewer sick visits with the doctor. The kids also watched less television and were more likely to be read to and to wear a helmet.

"I would encourage pediatric practices to do everything they can to become a medical home for their patients," said Dr. Webb Long of Boston University School of Medicine, who worked on the new study.

Often, medical homes offer after-hours consultation, translator services for non-English speaking families, and a home base for managing treatment plans and tests from specialist physicians.

Long and his colleagues, whose findings are published in the journal Pediatrics, looked through survey data from more than 70,000 children.

They found that about 40,000 had a medical home based on how the parents described their doctors' practices. Those kids were more likely to have had at least one preventive doctor visit in the past year than kids whose doctors didn't offer such comprehensive services.

They were also 29 percent less like to have gone to the doctor for a sick visit and 30 percent less likely to have been in the emergency room.

For instance, 21 out of every 100 kids without a medical home had been to the emergency room, compared to 16 out of every 100 kids who had a medical home.

"I think the health outcome results are what you would expect with a medical home," said Shirley Porterfield, a professor at the University of Missouri, St. Louis, who was not involved in this study. "Things are caught early, so they're less likely to end up in the emergency room."

Long pointed out that the survey couldn't determine whether the greater number of emergency room visits among the non-medical home group were unnecessary, nor whether the medical home was responsible for keeping kids out of the ER.

"But broadly speaking we view the decrease in outpatient visits and emergency department visits as a result of consulting through the medical home," Long told Reuters Health.

Long's group did not measure how much the medical home costs or saves in dollars.

In an earlier study of children with extra health care needs, Porterfield found that families spent less money out of pocket if the kids had a medical home. (See Reuters Health report of October 20, 2011.)

Although medical homes are becoming more available, the extra services are likely to cost doctors money, she said, because they are not typically paid for by insurance companies.

"It might be the best thing for the child's health, but not the best thing for the economics of that practice," said Long.

Long said that the reduced emergency department and outpatient visits might save money in overall health care spending.

Medical societies and the government have been encouraging doctors to adopt medical home practices.

The Centers for Medicare and Medicaid Services are conducting a large, multi-year project testing whether the medical home can improve health and reduce spending.

SOURCE: bit.ly/vuKUqX Pediatrics, online December 19, 2011.

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