Specialized primary care medical home: A positive impact on continuity of care among autistic adults.
Brittany N Hand, Daniel L Coury, Susan White and 5 others
PMID 32907353WHAT IT FOUND
Autistic adults in a specialized medical home had better continuity of care than those on Medicare, but similar to privately insured adults.
This suggests the model helps under-resourced groups reach consistent primary care, matching the access seen in private insurance.
Key findings
01After controlling for demographics, CAST patients had continuity of care indices 10% higher than national samples of autistic adult Medicare beneficiaries.
02CAST patients did not significantly differ from the national sample of privately insured autistic adults in continuity of care.
03Autistic adults with intellectual disabilities had continuity of care indices 7% lower than those without intellectual disability.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study relied on medical billing data, which may misclassify autism diagnoses and provider visits. Social determinants like race, ethnicity, and socioeconomic status were not controlled for, especially in the private insurance group. Visits made outside the CAST healthcare system were not captured, potentially underestimating continuity for CAST patients. The study did not measure patient satisfaction, quality of care, or whether healthcare needs were actually met. It is unknown if the comparison groups received care through other medical homes, which could bias results.
Declared interests
Funding was provided by the National Institute of Health (Extramural). No other conflicts of interest are explicitly detailed in the provided text.
The easy way to misread this
Do not conclude that the specialized medical home improves all health outcomes or patient satisfaction. The study only measured continuity of care (seeing the same provider), and found no significant difference when compared to privately insured adults, suggesting private insurance alone may provide similar access to consistent care.