Abstract
Objective
To explore medical home attributes of community health centers (CHCs) that provide
care to low-income children nationwide compared to other providers for the poor.
Methods
Cross-sectional study of children aged 0 to 17 years in the Medical Expenditure Panel
Survey (MEPS; 2003 to 2009) who resided in families living at <200% of the federal
poverty level (FPL) and had visits to a primary care setting. CHC visits were defined
as a visit to a neighborhood/family health center, rural health clinic, or community
health center. Independent measures included provider type, age, gender, race/ethnicity,
insurance, FPL, number of parents at home, language, maternal education, health status,
and special health care need. Dependent measures included 4 medical home attributes:
accessibility, and family-centered, comprehensive, and compassionate care.
Results
CHCs typically serve low-income children who are publicly insured or uninsured, come
from racial/ethnic minority groups, and have poorer health status. Eighty percent
to 90% of parents visiting both CHCs and other primary care providers rated high levels
of family-centered, comprehensive, and compassionate care. However, CHCs had a 10%
to 18% lower rating of accessibility (after-hours care, telephone access) even after
controlling for sociodemographic characteristics. Racial/ethnic disparities existed
at both settings, but these patterns did not differ between CHCs and other settings.
Conclusions
On the basis of parental reports, CHCs received similar ratings to other primary care
providers for family-centered, comprehensive, and compassionate care, but lower ratings
for accessibility. Further studies should examine strategies for practice transformation
in CHCs to improve patient satisfaction and accessibility to optimize child health
outcomes.
Keywords
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Article info
Publication history
Accepted:
June 17,
2013
Received:
September 21,
2012
Footnotes
The authors declare that they have no conflicts of interest.
Identification
Copyright
© 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
