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    A medical home far away from home

    If the medical home concept of team-based healthcare works for kids and their families in Peru, it will work in your community, too.


    Using this team-based approach, along with limited resource interventions (eg, transportation costs, support for needed testing, and more), we keep children moving through the system who otherwise would fall through the cracks. This model not only saves the patients and families heartache and significant financial impact, but also likely saves the overall health system valuable economic resources.

    Our success with this model demonstrates the importance of working with existing systems and structures to augment the scope and effectiveness of care. We do not seek to replace services, only to bridge gaps. Formative evaluation of the model is currently under way. We are measuring 8 separate indicators for each patient and seeking to develop a holistic understanding of the impact of the SYNC project.

    Pediatricians working in resource-limited settings inside or outside the United States have a unique opportunity to identify children who would benefit from similar coordination and advocacy. What works for our complex, resource-limited environment in Peru can work in similar environments in the United States and abroad.

    By thinking outside the normal paradigm of medical or surgical interventions, we can utilize coordination as perhaps a better use of energy and money for real, substantive change in health outcomes for the most fragile children.



    1. Medical Home Initiatives for Children With Special Needs Project Advisory Committee. American Academy of Pediatrics. The medical home. Pediatrics. 2002;110(1 pt 1):184-186.

    2. Buescher PA, Whitmire JT, Brunssen S, Kluttz-Hile CE. Children who are medically fragile in North Carolina: using Medicaid data to estimate prevalence and medical care costs in 2004. Matern Child Health J. 2006;10(5):461-466.

    3. Cohen E, Friedman JN, Mahant S, Adams S, Jovcevska V, Rosenbaum P. The impact of a complex care clinic in a children's hospital. Child Care Health Dev. 2010;36(4):574-582.

    4. Gordon JB, Colby HH, Bartelt T, Jablonski D, Krauthoefer ML, Havens P. A tertiary care-primary care partnership model for medically complex and fragile children and youth with special health care needs. Arch Pediatr Adolesc Med. 2007;161(10):937-944.

    5. Zandee GL, Bossenbroek D, Slager D, Gordon B. Teams of community health workers and nursing students effect health promotion of underserved urban neighborhoods. Public Health Nurs. 2013;30(5):439-447.

    6. Khanal S, Sharma J, GC VS, et al. Community health workers can identify and manage possible infections in neonates and young infants: MINI--a model from Nepal. J Health Popul Nutr. 2011;29(3):255-264.

    TO LEARN MORE ABOUT THE SYNC PROJECT and the Anglican Church of Peru’s medical mission, visit www.peru.anglican.org/harvestMedical.html, or send e-mail to Dr. Cooper at [email protected]. For information about Health Bridges International, visit http://hbint.org/ or contact Dr. Centrone at [email protected].  


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