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Medical Home Outcomes for School-Aged Children With Chronic Health Care Needs: A Mokken Analysis

Background and Objectives: We examined the structure of the medical home construct as well as the association of having a medical home with school outcomes among children with chronic health conditions. Methods: The current study utilized a combination of structural equation modeling, item response theory, and Mokken scaling techniques to determine how components of a medical home may be prioritized. The components of an operationally defined medical home were the main measures along with number of missed school days and the degree of interference with a child's school. Results: Results of the current study provide a clear structure for the components of a medical home using Mokken scaling analyses. These components of a medical home are important as they were associated with fewer missed school days and a lower likelihood of a child's condition interfering with school as reported by parents. Conclusion: With the results of the current study, providers working with schools can quickly discriminate (1) whether a child has a medical home and (2) understand how to guide parents toward a comprehensive medical home by understanding the hierarchy of medical home components.