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父母报告孩子拥有医疗之家是否会减弱低收入儿童未满足的基本需求与健康之间的负相关关系?

Does Parental Report of Having a Medical Home Attenuate the Negative Association Between Unmet Basic Needs and Health for Low-Income Children?

作者信息

Webb Rebecca, Whitham Anna, Tripodis Yorghos, Long Webb E, Garg Arvin

机构信息

Boston University School of Medicine, Boston Medical Center, Boston, MA, USA.

Boston University School of Public Health, Boston, MA, USA.

出版信息

Glob Pediatr Health. 2020 Dec 28;7:2333794X20985805. doi: 10.1177/2333794X20985805. eCollection 2020.

Abstract

It is unknown whether the medical home reduces the impact of adverse social determinants on low-income child health. To examine whether the medical home attenuates the association between unmet basic needs and health for low-income children. . Secondary data analysis of the 2011-12 NSCH restricted to <200% FPL children (n = 26 974). Multivariable logistic regression modeled child health with unmet basic needs to examine the effect modification of the medical home. Low-income children with unmet needs had lower odds of "excellent/very good" health compared to children without unmet needs, regardless of the medical home [aOR = 0.78 (0.61-0.99) vs aOR = 0.77 (0.63-0.94),  = .01), respectively]. The medical home did not modify the negative association between unmet basic needs and "excellent/very good" child health ( = .97). . Having a medical home per parental report did not attenuate the negative relationship between unmet basic needs and lowincome child health.

摘要

尚不清楚医疗之家是否能减轻不利社会决定因素对低收入儿童健康的影响。为了研究医疗之家是否能减弱低收入儿童未满足的基本需求与健康之间的关联。对2011 - 12年全国儿童健康调查(NSCH)中家庭收入低于联邦贫困线200%的儿童(n = 26974)进行二次数据分析。采用多变量逻辑回归模型,将儿童健康状况与未满足的基本需求进行建模,以检验医疗之家的效应修正。与没有未满足需求的儿童相比,有未满足需求的低收入儿童健康状况为“优秀/非常好”的几率更低,无论是否有医疗之家(调整后的比值比分别为0.78(0.61 - 0.99)和0.77(0.63 - 0.94),P = 0.01)。医疗之家并未改变未满足的基本需求与儿童“优秀/非常好”健康状况之间的负相关关系(P = 0.97)。根据父母报告,拥有医疗之家并未减弱未满足的基本需求与低收入儿童健康之间的负相关关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9060/7783885/93b177bfd55e/10.1177_2333794X20985805-fig1.jpg

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