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J Prim Care Community Health. 2014 Oct;5(4):253-62. doi: 10.1177/2150131914539814. Epub 2014 Jun 25.

Racial health disparities among special health care needs children with mental disorders: do medical homes cater to their needs?

Author information

  • 1The University of Texas, Austin, TX, USA.
  • 2The University of Michigan, Ann Arbor, MI, USA.
  • 3Penn State College of Medicine, Hershey, PA, USA.
  • 4Samford University, Birmingham, AL, USA jchang1@samford.edu.

Abstract

BACKGROUND:

A health care reform has been taking place to provide cost-effective and coordinated care. One method of achieving these goals is a patient-centered medical home (PCMH) model, which is associated with provision of quality care among children belonging to racial/ethnic minorities. Despite the potential of the PCMH for children of minority backgrounds, little is known about the extent to which minorities with mental disorders have the PCMH.

OBJECTIVE:

The study examined racial/ethnic disparities among children with mental disorders in accessing care from the PCMH.

METHODS:

The 2009-2010 National Survey of Children with Special Health Care Needs (CSHCN) was used for this analysis. Multivariate logistic regressions were applied to capture the racial/ethnic disparities and to analyze a composite outcome of the PCMH.

RESULTS:

An estimated population size of 4 677 904 CSHCN with mental disorders was included. Among them, 59.94% of children reported to have received medical homes. Compared with white children, the odds of receiving any medical home services decreased among Hispanic children (odds ratio [OR] = 0.69; P < .05) and black children (OR = 0.70; P < .05). The likelihood of having a medical home was lower for Hispanic children than white children, when they had attention deficit hyperactivity disorder (ADHD; OR = 0.57; P < .05) and development delay (OR = 0.73; P < .05). Compared with white children with ADHD or depression having a medical home, the odds of black children with ADHD (OR = 0.63; P < .05) and depression (OR = 0.68; P < .05) having a medical home were lower.

CONCLUSIONS:

There were significant racial/ethnic disparities among CSHCN with mental disorders, indicating several sizeable effects of each of the 5 components on Hispanic, black, and other children compared with white children. These differences could be a potential to improve racial/ethnic disparities.

© The Author(s) 2014.

KEYWORDS:

access to care; children; health outcomes; patient-centeredness; program evaluation

PMID:
24970879
[PubMed - indexed for MEDLINE]
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