Adolescent Access to Patient-Centered Medical Homes
| Autor: | Joanna D. Brown, Christina M Martone, Patrick M. Vivier, Annie Gjelsvik, Michelle L. Rogers |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Child Health Services Psychological intervention Ethnic group Special health care needs Logistic regression Health Services Accessibility Family centered care Odds 03 medical and health sciences 0302 clinical medicine Adolescent Medicine Patient-Centered Care 030225 pediatrics Odds Ratio Prevalence Humans Medicine 030212 general & internal medicine Healthcare Disparities Child Poverty Primary Health Care business.industry Health Status Disparities Hispanic or Latino United States Black or African American Cross-Sectional Studies Social Class Family medicine Multivariate Analysis Pediatrics Perinatology and Child Health Regression Analysis Female business Patient centered |
| Zdroj: | The Journal of Pediatrics. 213:171-179 |
| ISSN: | 0022-3476 |
| Popis: | Objectives To analyze the distribution of patient-centered medical homes (PCMHs) among US adolescents, and to examine whether disparities exist among subgroups. Study design Data on adolescents ages 12-17 years (n = 34 601) from the 2011-2012 National Survey of Children's Health were used in this cross-sectional study to determine what proportion had access to a PCMH. Multivariable logistic regression was used to calculate the odds of having a PCMH, adjusting for sociodemographic characteristics and special health care needs. Comparisons were made to distribution of PCMH in 2007. Results Although most US adolescents had a usual source of care (91%), only about one-half (51%) had access to a PCMH. Disparities in the prevalence of PCMHs were seen by race/ethnicity, poverty, and having special health care needs. There were lower adjusted odds in having a PCMH for Hispanic (aOR, 0.56; 95% CI, 0.45-0.68) and black adolescents (aOR, 0.55; 95% CI, 0.46-0.66) compared with white adolescents. Those living below 4 times the poverty level had lower adjusted odds of PCMH access. Adolescents with 3-5 special health care needs had lower adjusted odds (aOR, 0.43; 95% CI, 0.35-0.52) of having a PCMH compared with adolescents without any special health care needs. Other than receiving family centered care, every component of PCMH was slightly lower in 2011-2012 compared with 2007. Conclusions PCMH access was lower among minorities, those living in poverty, and those with multiple special health care needs. These disparities in PCMH access among these typically underserved groups call for further study and interventions that would make PCMHs more accessible to all adolescents. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect