Community Health Centers: Medical Homes for Children?

Authors, Primary Hoilette,Leesha K.;Blumkin,Aaron K.;Baldwin,Constance D.;Fiscella,Kevin;Szilagyi,Peter G.
Title Primary Community Health Centers: Medical Homes for Children?
Periodical Full Academic Pediatrics
Pub Year 2013
Volume 13
issue 5
Start Page 436-442
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.
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Reference Type(s) Journal Article
Topic Tag(s) Patient-Centered Care;Disparities
Special Population(s) Children with Special Needs;Children without Special Needs
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