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  • Title: Socioeconomic and Racial Disparities in Parental Perception and Experience of Having a Medical Home, 2007 to 2011-2012.
    Author: Diao K, Tripodis Y, Long WE, Garg A.
    Journal: Acad Pediatr; 2017; 17(1):95-103. PubMed ID: 27457406.
    Abstract:
    OBJECTIVE: To evaluate whether socioeconomic (SES) and racial disparities in the parental perception and experience of having a medical home decreased from 2007 to 2011-2012. METHODS: We used nationally representative samples of children aged 1 to 17 from the 2007 (n = 83,293) and 2011-2012 (n = 87,774) National Surveys of Children's Health. Multivariable logistic regression was used to test associations between SES (income, employment, and education) and race/ethnicity to the medical home and its subcomponents (personal doctor or nurse, usual source of care, family-centered care, referrals, care coordination), controlling for a priori identified covariates. RESULTS: From 2007 to 2011-2012, fewer children overall had access to a medical home (56.9% vs 54.0%, aOR = 0.91, 95% confidence interval 0.86-0.96). There were no significant changes in SES and racial trends in access to the medical home during this time period. For example, parents of children <100% federal poverty level (FPL) were significantly less likely to report having a medical home than parents of children ≥400% FPL in 2007 and 2011-2012; however, this disparity did not significantly change during the time period (aOR = 0.98, 95% confidence interval 0.75-1.27). There were also no significant changes in SES and racial/ethnic disparities over time for each medical home subcomponent. CONCLUSIONS: Despite widespread efforts to promote the medical home for all children, large SES and racial disparities in the parental perception and experience of having a medical home persisted from 2007 to 2011-2012.
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