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Medical Home Project

Goal: To document systematically how young adults with mobility limitation experience the health care structure, process and outcomes in moving from pediatric to adult health care, within the context of four mutually exclusive transition states: 1) receive all care from pediatric providers, 2) receive care from both pediatric and adult providers, 3) receive all care from adult providers, or 4) having no connection with the health care system.

Aims: 1) To examine relationships between level of mobility limitation and health care structure (i.e., care in a medical home, transition status, health insurance status), 2) To examine relationships between level of mobility limitation and health care process (access to care, perceived need, use of health services), and 3) To examine relationships between level of mobility limitation and perceived health status.

Significance: Persons' with disabilities face many challenges, including the myriad issues involved with having a mobility limitation. One of the most significant issues that young adults with mobility limitation face is making the transition from pediatric to adult health care. The Surgeon General and numerous organizations recognize that this adult care at a minimum should be accessible, personal, comprehensive, coordinated, high-quality, and inclusive of both preventive and treatment services.

Innovation: This project would deepen our understanding of health services for those making the transition from pediatric to adult health care services. Our survey picks up where the NS-CSHCN left off in terms of age thereby allowing us to draw inferences about members of this population who are in all stages of the pediatric transition and prepare for a probability sample survey.

Methods and Analysis: These aims will be addressed in an age and gender-balanced nationwide sample of n=500 young adults with mobility limitation ages 18-29 years. We shall use survey questions on health service access, use and need from the NSCSHCN, thus giving us the ability to compare our results to national data.

Investigators: An interdisciplinary team of researchers in health services, rehabilitation medicine, sociology, public health, social psychology, disability studies, and community partners, including primary and secondary consumers of mobility disability services.

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