New UCLA study looks at primary care medical home in reducing childrens' repeat visits to hospitals

It's a question of major importance to parents, health policy makers and health care professionals — and a focus of national health care quality improvement initiatives. What keeps children from being readmitted to hospitals in the weeks after they're discharged?

Previous research on the subject has focused on the role that hospitals play in the equation. But a new study by doctors at UCLA looked at five factors revolving around the primary physician's office.

Those factors, collectively known as the "primary care medical home," consider whether the child has a personal doctor or nurse, a "usual place" to receive sick and well care, "family-centered care" (which addresses family's overall needs rather than just the illness), an easy time obtaining referrals to specialists, and coordinated care (in which seamless care occurs across specialties, providers and systems).

It turned out that just one of those medical home factors was the most reliable predictor of whether a child would be readmitted to a hospital or emergency room within a month after being discharged: having a routine place to receive sick and well care.

Among children without a consistent place to receive well and sick care, 22 percent were readmitted to the hospital within a month; among those who did have a consistent place for well and sick care, just 10 percent were. In addition, 8 percent of children without a usual place for well and sick care went to a hospital emergency department within seven days of their discharge, versus just 5 percent of children who did have a usual source for well and sick care.