Top

Published in:

01-02-2018

How Well is the Medical Home Working for Latino and Black Children?

Authors: Alma D. Guerrero, Xinkai Zhou, Paul J. Chung

Published in: Maternal and Child Health Journal | Issue 2/2018

Abstract

Objective To examine the benefits of having a medical home among Latino and Black school-aged children, both with and without special health care needs (CSHCN). Methods Data from the 2011–2012 National Survey of Children’s Health (NSCH) were analyzed to examine the associations of preventive dental and medical care, unmet dental or medical care, or missed school days with having a medical home among Latino and Black children compared to White children. Multivariate logistic regression with survey weights was used to adjust for child, parent, home, and geographic characteristics and an interaction term to estimate differences in outcomes among Black or Latino children receiving care in a medical home compared to White children with a medical home. Results Approximately 35% of Latino CSHCN and Latino non-CSHCN ages 6–17 years of age had a medical home. In the adjusted model comparing the effectiveness of the medical home by race and ethnicity, Latino non-CSHCN compared to White non-CSHCN were associated with lower odds of having one or more preventive dental visit in the last 12 months (OR 0.66; 95% CI 0.46–0.95) and no other associations between having a medical home and outcomes were found among Latinos compared to Whites regardless of non-CSHCN or CHSCN status. Meanwhile, having a medical home among Black non-CHSCN and CHSCN, compared to their White counterparts, showed potential benefits in regards to unmet medical care needs after adjusting for covariates, (OR 0.15; 95% CI 0.06–0.35; OR 0.16; 95% CI 0.05–0.55). Conclusions Medical homes may not be effective in delivering health services to the majority of Latino children but provide some benefit to Black children with and without CSHCN. Alternatively, the medical home may function differently for Latinos due to the specific medical home components measured by NSCH.

Available only for authorised users

Adams, S. H., Newacheck, P. W., Park, M. J., et al. (2013). Medical home for adolescents: Low attainment rates for those with mental health problems and other vulnerable groups. Academic Pediatrics, 13(2), 113–121. https://doi.org/10.1016/j.acap.2012.11.004.CrossRefPubMed

American Academy of Family Physicians. (2008). Joint principles of the patient-centered medical home. DeLaware Medical Journal, 80(1), 21–22.

Berry, J. G., Bloom, S., Foley, S., et al. (2010). Health inequity in children and youth with chronic health conditions. Pediatrics, 126(Suppl 3), 111–119. https://doi.org/10.1542/peds.2010-1466D.CrossRef

Blumberg, S. J., Foster, E. B., Frasier, A. M., et al. (2012). Design and operation of the National Survey of Children’s Health, 2007. Vital Health Stat 1, 55, 1–149.

Centers for Disease Control and Prevention NCfHS. Centers for Disease Control and Prevention, National Center for Health Statistics, State and Local Area Integrated Telephone Survey. 2011–2012. National Survey of Children’s Health Frequently Asked Questions. April 2013.

Cooley, W. C., McAllister, J. W., Sherrieb, K., et al. (2009). Improved outcomes associated with medical home implementation in pediatric primary care. Pediatrics, 124(1), 358–364. https://doi.org/10.1542/peds.2008-2600.CrossRefPubMed

DeCamp, L. R., Choi, H., & Davis, M. M. (2011). Medical home disparities for Latino children by parental language of interview. Journal of Health Care for the Poor and Underserved, 22(4), 1151–1166. https://doi.org/10.1353/hpu.2011.0113.CrossRefPubMedPubMedCentral

DuMontier, C., Rindfleisch, K., Pruszynski, J., et al. (2013). A multi-method intervention to reduce no-shows in an urban residency clinic. Family Medicine, 45(9), 634–641.PubMed

Flores, G., Olson, L., & Tomany-Korman, S. C. (2005). Racial and ethnic disparities in early childhood health and health care. Pediatrics, 115(2), e183–e193. https://doi.org/10.1542/peds.2004-1474.CrossRefPubMed

Guerrero, A. D., Rodriguez, M. A., & Flores, G. (2011). Disparities in provider elicitation of parents’ developmental concerns for US children. Pediatrics, 128(5), 901–909. https://doi.org/10.1542/peds.2011-0030.CrossRefPubMed

Hadland, S. E., & Long, W. E. (2014). A systematic review of the medical home for children without special health care needs. Maternal and Child Health Journal, 18(4), 891–898. https://doi.org/10.1007/s10995-013-1315-9.CrossRefPubMed

Homer, C. J., Klatka, K., Romm, D., et al. (2008). A review of the evidence for the medical home for children with special health care needs. Pediatrics, 122(4), e922–e937. https://doi.org/10.1542/peds.2007-3762.CrossRefPubMed

Initiative DRCfCaAHTCaAHM. Measuring Medical Home for Children and Youth. May 2009.

Kim, Y. O. (2005). Reducing disparities in dental care for low-income Hispanic children. Journal of Health Care for the Poor and Underserved, 16(3), 431–443. https://doi.org/10.1353/hpu.2005.0052.CrossRefPubMed

Long, W. E., Bauchner, H., Sege, R. D., et al. (2012). The value of the medical home for children without special health care needs. Pediatrics, 129(1), 87–98. https://doi.org/10.1542/peds.2011-1739.CrossRefPubMedPubMedCentral

Lopez, C., Bergren, M. D., & Painter, S. G. (2008). Latino disparities in child mental health services. Journal of Child and Adolescent Psychiatric Nursing, 21(3), 137–145. https://doi.org/10.1111/j.1744-6171.2008.00146.x.CrossRefPubMed

Medical Home Initiatives for Children With Special Needs Project Advisory Committee, American Academy of Pediatrics (2002) The medical home. Pediatrics, 110(1 Pt 1), 184–186.CrossRef

Ngui, E. M., & Flores, G. (2007). Unmet needs for specialty, dental, mental, and allied health care among children with special health care needs: Are there racial/ethnic disparities? Journal of Health Care for the Poor and Underserved, 18(4), 931–949. https://doi.org/10.1353/hpu.2007.0102.CrossRefPubMed

Ortega, A. N., Stewart, D. C., Dowshen, S. A., et al. (2000). The impact of a pediatric medical home on immunization coverage. Clinical Pediatrics, 39(2), 89–96.CrossRefPubMed

Park, C., Tan, X., Patel, I. B., et al. (2014). Racial health disparities among special health care needs children with mental disorders: Do medical homes cater to their needs? Journal of Primary Care & Community Health, 5(4), 253–262. https://doi.org/10.1177/2150131914539814.CrossRef

Raphael, J. L., Guadagnolo, B. A., Beal, A. C., et al. (2009a). Racial and ethnic disparities in indicators of a primary care medical home for children. Academic Pediatrics, 9(4), 221–227. https://doi.org/10.1016/j.acap.2009.01.011.CrossRefPubMed

Raphael, J. L., Zhang, Y., Liu, H., et al. (2009b). Association of medical home care and disparities in emergency care utilization among children with special health care needs. Academic Pediatrics, 9(4), 242–248. https://doi.org/10.1016/j.acap.2009.05.002.CrossRefPubMed

Rittenhouse, D. R., Shortell, S. M., & Fisher, E. S. (2009). Primary care and accountable care—Two essential elements of delivery-system reform. The New England Journal of Medicine, 361(24), 2301–2303. https://doi.org/10.1056/NEJMp0909327.CrossRefPubMed

Sia, C., Tonniges, T. F., Osterhus, E., et al. (2004). History of the medical home concept. Pediatrics, 113(5 Suppl), 1473–1478.PubMed

Stevens, G. D., Vane, C., & Cousineau, M. R. (2011). Association of experiences of medical home quality with health-related quality of life and school engagement among Latino children in low-income families. Health Services Research, 46(6pt1), 1822–1842. https://doi.org/10.1111/j.1475-6773.2011.01292.x.CrossRefPubMedPubMedCentral

Strickland, B. B., Singh, G. K., Kogan, M. D., et al. (2009). Access to the medical home: New findings from the 2005–2006 National Survey of Children with Special Health Care Needs. Pediatrics, 123(6), e996–e1004. https://doi.org/10.1542/peds.2008-2504.CrossRefPubMed

U.S. Census Bureau. (2010). Census summary. Retrieved July 7, 2015 from http://2010.census.gov/2010census/.

Yu, S. M., & Singh, G. K. (2009). Household language use and health care access, unmet need, and family impact among CSHCN. Pediatrics, 124(Suppl 4), 414–419. https://doi.org/10.1542/peds.2009-1255M.CrossRef

Title: How Well is the Medical Home Working for Latino and Black Children?
Authors: Alma D. Guerrero
Xinkai Zhou
Paul J. Chung
Publication date: 01-02-2018
Publisher: Springer US
Published in: Maternal and Child Health Journal / Issue 2/2018
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-017-2389-6

ACC 2024 Congress

Springer Medicine

How Well is the Medical Home Working for Latino and Black Children?

Abstract

ACC 2024 Congress

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2018

Maternal Health Behaviors and Outcomes in a Nomadic Tibetan Population

After The Demonstration: What States Sustained After the End of Federal Grants to Improve Children’s Health Care Quality

Dimensionality and R4P: A Health Equity Framework for Research Planning and Evaluation in African American Populations

Innovations in Maternal and Child Health: Pairing Undergraduate and Graduate Maternal and Child Health Students in Summer Practica in State Title V Agencies

Paid Maternity Leave in the United States: Associations with Maternal and Infant Health

Maternal Hypertension, Antihypertensive Medication Use, and Small for Gestational Age Births in the National Birth Defects Prevention Study, 1997–2011