Socioeconomic and Racial Disparities in Parental Perception and Experience of Having a Medical Home, 2007 to 2011–2012

Abstract

ObjectiveTo evaluate whether socioeconomic (SES) and racial disparities in the parental perception and experience of having a medical home decreased from 2007 to 2011–2012. MethodsWe 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. ResultsFrom 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. ConclusionsDespite 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.