Do Medical Homes Reduce Disparities in Receipt of Preventive Services Between Children Living in Immigrant and Non-immigrant Families?

Abstract

The patient-centered medical home model has the potential to reduce healthcare disparities among immigrant children. The purpose of this study is to examine the relationship between medical home (MH) participation and receipt of preventive services among immigrant children age 0–17. The study employed extant data from the National Survey of Children’s Health, 2007 (NSCH). Logistic regression analyses were employed to assess the relationship between receipt of preventive services and MH status among immigrant and non-immigrant children. Due to primarily the lack of family-centered care, only 40% of immigrant children met the medical home criteria versus approximately 62% of non-immigrant children. Immigrant children have decreased odds of receiving preventive care despite MH status. Improving the family-centered care aspect of the MH is necessary to increasing medical home access to immigrant children and the receipt of preventive services for immigrant children who meet the MH criteria.

Immigrant Families, Children With Special Health Care Needs, and the Medical Home

“…Medical home disparities for immigrant versus nonimmigrant children have been previously described, 26 but our study reveals heterogeneity in medical home presence among children from different immigrant family types (ie, for foreign-born children and children with a foreign-born parent).…”

The Patient-Centered Medical Home

“…These studies found mixed results with some showing lower disparities and others persistent disparities or varying effects among racial/ethnic groups (Aysola et al, 2013;BeLue et al, 2012). Our contribution indicates that educational and income disparities persist in the group of respondents with providers that have medical home characteristics.…”

Nativity as a Determinant of Health Disparities Among Children

“…Immigrants from diverse racial/ethnic groups may be underrepresented even in studies where they are not excluded because data are obtained from surveys administered only in English and Spanish (7, 8, 31) and immigrants are geographically concentrated within certain areas of the US(32). Data from previous studies suggest both child and parental nativity should be considered when assessing health measures among children (19, 20, 27, 30, 33), yet many consider only that of the child (1, 2, 11, 23, 34–36) or parent(3, 15, 17, 37). This study examines the role of nativity on parent-reported health status in a racially and ethnically diverse population.…”