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

Alma D Guerrero1,2,3, Xinkai Zhou4, Paul J Chung5,6,7,8

  • 1Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. aguerrero@mednet.ucla.edu.

Maternal and Child Health Journal
|November 12, 2017
PubMed

Insights

A medical home model shows benefits for Black children, reducing unmet medical care needs. However, it appears less effective for Latino children, particularly regarding preventive dental visits.

Area of Science:

  • Pediatric Health Services Research
  • Health Equity Studies
  • Child Health Outcomes

Background:

  • The concept of a medical home is crucial for coordinating care in children, especially those with special health care needs (CSHCN).
  • Understanding racial and ethnic disparities in accessing and benefiting from medical home models is essential for improving child health equity.
  • Previous research indicates varying access and effectiveness of healthcare models across different demographic groups.

Purpose of the Study:

  • To investigate the advantages of a medical home for Latino and Black school-aged children, considering those with and without special health care needs (CSHCN).
  • To compare the outcomes of medical home utilization among Latino and Black children against their White peers.
  • To identify potential differences in the effectiveness of the medical home model across racial and ethnic groups.

Main Methods:

  • Analysis of data from the 2011-2012 National Survey of Children's Health (NSCH).
  • Utilized multivariate logistic regression with survey weights to adjust for various child, parent, home, and geographic characteristics.
  • Included an interaction term to specifically estimate differences in outcomes for Black and Latino children in a medical home compared to White children with a medical home.

Main Results:

  • Approximately 35% of Latino children (both CSHCN and non-CSHCN) utilized a medical home.
  • Latino non-CSHCN had lower odds of receiving preventive dental visits compared to White non-CSHCN (OR 0.66).
  • No other significant associations were found for Latino children regarding medical home benefits.
  • Black non-CSHCN and CSHCN showed potential benefits with reduced unmet medical care needs compared to White counterparts (ORs 0.15 and 0.16, respectively).

Conclusions:

  • The medical home model may not be universally effective in delivering health services to Latino children.
  • The medical home appears to offer some benefits to Black children, irrespective of their CSHCN status.
  • Differences in the measured components of a medical home within the NSCH may influence its perceived function for Latino populations.

Keywords:
Children with special health care needsChildren without special health care needsLatino childrenMedical homeRacial/ethnic health disparities

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