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Factors Associated with Having a Medical Home for Children At-Risk of Experiencing Negative Events: Results from a

Jacqueline Baron-Lee1, Brandy Bonner2, Caprice Knapp3

  • 1Department of Neurosurgery, University of Florida, PO Box 100265, Gainesville, FL, 32611, USA. jbaronlee@ufl.edu.

Maternal and Child Health Journal
|May 25, 2015
PubMed

Insights

Family and environmental risks, including adverse childhood experiences (ACEs), are linked to lower odds of children having a medical home. Addressing these risks is crucial for ensuring equitable access to comprehensive healthcare.

Area of Science:

  • Pediatric Health Services Research
  • Social Determinants of Health
  • Childhood Adversity

Background:

  • The Patient-Centered Medical Home (PCMH) is an optimal care model, yet not all children access it.
  • Clinical and practitioner factors influence PCMH access, but family and environmental risks, like adverse childhood experiences (ACEs), may also play a role.

Purpose of the Study:

  • To investigate the association between family and environmental risks and children's access to a medical home.
  • To determine if adverse childhood experiences (ACEs) impact the likelihood of a child having a medical home.

Main Methods:

  • Utilized data from the nationally representative 2011-2012 National Survey of Children's Health (N = 95,677).
  • Conducted cross-sectional analyses to examine associations between family/environmental risks and medical home status.
  • Modeled a subset of risks based on seminal ACEs research.

Main Results:

  • Nearly a quarter of children experienced at least one ACE.
  • Children with ACEs or other family/environmental risks had significantly lower odds of having a medical home.
  • Cumulative ACEs (OR 0.76) and other risks (OR 0.36) were associated with reduced odds of PCMH access.

Conclusions:

  • Family and environmental risks, including ACEs, significantly impact parental reports of children having a medical home.
  • A potential dosage effect suggests that higher cumulative risk exposure further decreases the likelihood of PCMH access.
  • Healthcare providers must consider ACEs and other risk factors when caring for children vulnerable to adverse events.
Abstract

Keywords:
Adverse childhood experiencesHealth care deliveryMedical homePrimary careSocial determinants of health

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