Introduction. The American Academy of Pediatrics medical home concept is similar to the primary care concept except that the AAP's definition also incorporates access to inpatient and ambulatory care for acute illnesses 24 hours a day, 365 days a year. Having an adequate medical home should improve utilization behaviors, and, therefore, improve the health of children. However, the relationship between access and utilization in pediatric populations has not been fully established. Further, it is not sufficient to just have a medical home available. Caretakers must also be aware of the services that are available. This study examines both the relationships between adequacy of access to a medical home with utilization and perceptions of access with utilization. The Medical Home Scale (MHS) is developed and tested for reliability.

Methods. Two independent samples of Delaware children ages 6-36 months are used. The first sample is a simple random population-based sample(response=495/1004) selected from the Delaware birth certificate registry. The second sample is a probabilities proportional to size (PPS) sample(response=323/1,098) of children who attend one of the Nemours Clinics of the duPont Hospital for Children. Caretakers were mailed Child Quest 2000 questionnaires.

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