Fleary Sasha A
Tufts University, Medford, MA, USA.
Clin Pediatr (Phila). 2019 Mar;58(3):270-281. doi: 10.1177/0009922818813568. Epub 2018 Nov 18.
Given the medical home model of care's (MHMOC) potential to reduce disparities in health care, this study determined the relationship between MHMOC, MHMOC indicators, and (1) demographic characteristics and (2) health outcomes in US children. Caregivers (n = 50 212) of children 0 to 17 years completed the 2016 National Survey of Children's Health. The MHMOC measure comprised 5 indicators (e.g., having a personal doctor/nurse and receiving family-centered care). Bivariate and multiple logistic regressions assessed the relationships between MHMOC, MHMOC indicators, and (1) demographic characteristics and (2) health outcomes. Approximately 49% of the children were served in a MHMOC. MHMOC and MHMOC indicators were related to race, ethnicity, nativity, caregiver education, federal poverty level, insurance type, and predicted health outcomes. These findings suggest that children most in need of MHMOC are less likely to be served in them. Thus, the current distribution of MHMOC likely contributes to greater disparities in care.
鉴于医疗之家护理模式（MHMOC）在减少医疗保健差异方面的潜力，本研究确定了MHMOC、MHMOC指标与（1）美国儿童的人口统计学特征以及（2）健康结果之间的关系。0至17岁儿童的照顾者（n = 50212）完成了2016年全国儿童健康调查。MHMOC测量包括5项指标（例如，有私人医生/护士以及接受以家庭为中心的护理）。双变量和多因素逻辑回归分析评估了MHMOC、MHMOC指标与（1）人口统计学特征以及（2）健康结果之间的关系。约49%的儿童接受了MHMOC服务。MHMOC和MHMOC指标与种族、族裔、出生地、照顾者教育程度、联邦贫困水平、保险类型以及预测的健康结果相关。这些发现表明，最需要MHMOC服务的儿童获得此类服务的可能性较小。因此，MHMOC目前的分布情况可能会导致更大的医疗保健差异。
