Objective
Racial/ethnic disparities in access to care across a broad range of health services
have been well established. In adults, having a medical home has been shown to reduce
disparities. The objective of this study was to assess the extent to which children
of different race/ethnicities receive primary care consistent with a medical home.
Methods
We conducted a secondary analysis of 84 101 children, ages 0–17, from the 2003–2004
National Survey of Children's Health, a nationwide household survey. The primary independent
variable was race/ethnicity of the child. The main dependent variable was a medical
home as defined by the American Academy of Pediatrics. Multiple logistic regression
was conducted to investigate associations between race/ethnicity and having a medical
home.
Results
The odds of having a medical home were lower for non-Hispanic black (odds ratio [OR]
0.76, 95% confidence interval [95% CI] 0.69–0.83), Hispanic (OR 0.80, 95% CI 0.72–0.89),
and other (OR 0.77, 95% CI 0.69–0.87) children compared with non-Hispanic white children
after adjusting for sociodemographic variables. Specific components of a medical home
for which minority children had a lower odds (P < .01) of having compared with white children included having a personal provider,
a provider who always/usually spent enough time with them, and a provider who always/usually
communicated well.
Conclusions
Minority children experienced multiple disparities compared with white children in
having a medical home. Study of individual medical home components has the potential
to identify specific areas to improve disparities.
Key Words
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Article Info
Publication History
Published online: June 01, 2009
Accepted:
January 30,
2009
Received:
July 29,
2008
Identification
Copyright
© 2009 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
