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Acad Pediatr. 2013 Sep-Oct;13(5):436-42. doi: 10.1016/j.acap.2013.06.006.

Community health centers: medical homes for children?

Author information

1
Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY. Electronic address: leesha_hoilette@urmc.rochester.edu.

Abstract

OBJECTIVE:

To explore medical home attributes of community health centers (CHCs) that provide care to low-income children nationwide compared to other providers for the poor.

METHODS:

Cross-sectional study of children aged 0 to 17 years in the Medical Expenditure Panel Survey (MEPS; 2003 to 2009) who resided in families living at <200% of the federal poverty level (FPL) and had visits to a primary care setting. CHC visits were defined as a visit to a neighborhood/family health center, rural health clinic, or community health center. Independent measures included provider type, age, gender, race/ethnicity, insurance, FPL, number of parents at home, language, maternal education, health status, and special health care need. Dependent measures included 4 medical home attributes: accessibility, and family-centered, comprehensive, and compassionate care.

RESULTS:

CHCs typically serve low-income children who are publicly insured or uninsured, come from racial/ethnic minority groups, and have poorer health status. Eighty percent to 90% of parents visiting both CHCs and other primary care providers rated high levels of family-centered, comprehensive, and compassionate care. However, CHCs had a 10% to 18% lower rating of accessibility (after-hours care, telephone access) even after controlling for sociodemographic characteristics. Racial/ethnic disparities existed at both settings, but these patterns did not differ between CHCs and other settings.

CONCLUSIONS:

On the basis of parental reports, CHCs received similar ratings to other primary care providers for family-centered, comprehensive, and compassionate care, but lower ratings for accessibility. Further studies should examine strategies for practice transformation in CHCs to improve patient satisfaction and accessibility to optimize child health outcomes.

KEYWORDS:

children; community health centers; medical home; safety net

PMID:
24011746
DOI:
10.1016/j.acap.2013.06.006
[Indexed for MEDLINE]
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