Pediatrics: Children's access to medical homes limited

Only 57 percent of children in the U.S. have access to a medical home, according to researchers at the Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau.

“Children without a medical home are nearly four times more likely to have unmet needs for healthcare, three times more likely to have unmet needs for dental care and were less likely to have had a preventive health care visit in the past year,” wrote Bonnie B. Strickland, MD, a researcher in HRSA’s Maternal and Child Health Bureau, and colleagues in the April issue of Pediatrics.

The report, “The Medical Home: Health Care Access and Impact for Children and Youth in the United States,” uses data from the HRSA 2007 National Survey of Children’s Health. The researchers defined a medical home as a model of primary care that is accessible, continuous, comprehensive, family-centered, coordinated, compassionate and culturally effective.

Insured children were almost twice as likely to have medical homes as uninsured children, according to the authors. The study also examined disparities in medical home access among racial and ethnic groups. While non-Hispanic whites had the greatest access to a medical home, Hispanic children were at the greatest risk of not having a medical home and non-Hispanic black children fared only slightly better, according to the authors.

Medical home access was twice as prevalent among children in families in which English was the primary language, the organization found. “Children in fair or poor health were about half as likely as healthier children to have a medical home,” the researchers noted. 

"Because the medical home is increasingly promoted as the standard for provision of high-quality comprehensive healthcare, these findings reinforce the need to continue and expand federal, state and community efforts to ensure that all children have access to this model of care,” Strickland and colleagues concluded.
 

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