Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, California.
Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, California.
J Adolesc Health. 2023 Oct;73(4):790-794. doi: 10.1016/j.jadohealth.2023.05.019. Epub 2023 Jun 27.
Despite long-term emphasis on the medical home for children, little research focuses on adolescents. This study examines adolescent past-year attainment of medical home, its components, and subgroup differences among demographic and mental/physical health condition categories.
Utilizing the 2020-21 National Survey of Children's Health (NSCH), ages 10-17 (N = 42,930), we determined medical home attainment and its 5 components and subgroup differences utilizing multivariable logistic regression: sex; race/ethnicity; income; caregiver education; insurance; language spoken at home; region; and health conditions: physical, mental, both, or none.
Forty-five percent had a medical home with lower rates among those who were as follows: not White non-Hispanic; lower income; uninsured; in non-English-speaking households; adolescents whose caregivers lacked a college degree; and adolescents with mental health conditions (p range = .01-<.0001). Differences for medical home components were similar.
Given low medical home rates, ongoing differences and high mental illness rates, efforts are needed to improve adolescent medical home access.
尽管长期以来一直强调儿童的医疗之家,但很少有研究关注青少年。本研究考察了青少年在过去一年中获得医疗之家及其组成部分的情况,以及在人口统计学和心理健康/身体健康状况类别中的亚组差异。
利用 2020-21 年全国儿童健康调查(NSCH),年龄在 10-17 岁(N=42930),我们利用多变量逻辑回归确定了医疗之家的获得情况及其 5 个组成部分以及亚组差异:性别;种族/民族;收入;照顾者的教育程度;保险;在家中使用的语言;地区;以及健康状况:身体、心理、两者或都没有。
有 45%的青少年有医疗之家,但以下人群的比例较低:非白人和非西班牙裔;收入较低;没有保险;在家中不说英语;照顾者没有大学学位的青少年;以及有心理健康问题的青少年(p 值范围为.01-<.0001)。医疗之家组成部分的差异也类似。
鉴于医疗之家的比例较低,差异持续存在且心理健康问题的比例较高,需要努力改善青少年获得医疗之家的机会。