Zickafoose Joseph S, Davis Matthew M
J Health Care Poor Underserved. 2013 Aug;24(3):1331-43. doi: 10.1353/hpu.2013.0117.
To identify components of the medical home that contribute to medical home disparities for vulnerable children.
Cross-sectional analysis of 2007 National Survey of Children's Health. Prevalence of components of the medical home were estimated by special health care needs (SHCN), race/ethnicity, primary language, and health insurance.
Medical home disparities for children with SHCN were driven by differences in getting help with care coordination, when needed (71% vs. 91% children without SHCN, p<.001). Medical home disparities for other groups were largely attributable to less family-centered care (Hispanic 49% and African American 55% vs. White 77%, p<.001; non-English primary language 37% vs. English 72%, p<.001; uninsured 45% and publicly insured 57% vs. privately insured 75%, p<.001).
The components of the medical home that contribute to medical home disparities differ between groups of vulnerable children. Medical home implementation may benefit from focusing on the specific needs of target populations.
确定医疗之家的组成部分中导致弱势儿童医疗之家差异的因素。
对2007年全国儿童健康调查进行横断面分析。通过特殊医疗需求（SHCN）、种族/民族、主要语言和健康保险来估计医疗之家各组成部分的患病率。
有特殊医疗需求儿童的医疗之家差异是由在需要时获得护理协调帮助方面的差异所驱动的（有特殊医疗需求的儿童为71%，无特殊医疗需求的儿童为91%，p<0.001）。其他群体的医疗之家差异很大程度上归因于以家庭为中心的护理较少（西班牙裔为49%，非裔美国人为55%，而白人为77%，p<0.001；以非英语为主要语言的为37%，以英语为主要语言的为72%，p<0.001；未参保的为45%，公共保险的为57%，而私人保险的为75%，p<0.001）。
导致医疗之家差异的医疗之家组成部分在弱势儿童群体之间有所不同。医疗之家的实施可能会因关注目标人群的特定需求而受益。
