Exploring the meso-system: the relationship between unmet health care needs, access to medical home services, and parent-perceived autism severity

Children with special health care needs (CSHCN) are often accompanied by substantial unmet health care needs (UHCNs), especially for children with autism spectrum disorders (ASD). The concept of a medical home (MH) provides a family-centered and community-based health care service delivery model to address these UHCNs, which is associated with significant improvement in quality of care and patient satisfaction. However, fewer than one in five children with ASD have access to MH services. At present, very few published research studies have explored access to MH services of children with ASD or the extent of their UHCNs. Applying data from the 2018-2019 National Survey of Children’s Health (NSCH), this study explored the relationship between UHCNs, access to MH services, and caregiver-reported ASD severity from an ecological perspective, specifically looking at the environmental factors and interactions between the child’s family and the health care system. Results showed that having an ASD diagnosis was significantly associated with UHCNs and access to MH services. Certain UHCN types and UHCN barrier types had a significant relationship with ASD severity. For children with ASD, UHCN status and access to MH services also demonstrated a significant relationship. Implications for research and practice are discussed.