Maternal and Child Health Journal

, Volume 16, Supplement 1, pp 6–13

Medical Home Access Among American Indian and Alaska Native Children in 7 States: National Survey of Children’s Health

  • Danielle T. Barradas
  • Charlan D. Kroelinger
  • Michael D. Kogan
Article

DOI: 10.1007/s10995-012-0990-2

Cite this article as:
Barradas, D.T., Kroelinger, C.D. & Kogan, M.D. Matern Child Health J (2012) 16(Suppl 1): 6. doi:10.1007/s10995-012-0990-2

Abstract

To describe the prevalence of medical home among American Indian and Alaska Native children (AIAN) compared to non-Hispanic white (NHW) children and identify areas for improvement in the provision of care within a medical home. Prevalence of medical home, defined as family-centered, comprehensive, coordinated, compassionate, culturally effective care, including a personal doctor or nurse and usual care location, was estimated using 2007 National Survey of Children’s Health data. Analyses included 1–17 year-olds in states reporting AIAN race as a distinct category (Alaska, Arizona, Montana, New Mexico, North Dakota, Oklahoma, and South Dakota, n = 9,764). Associations between medical home and demographic (child’s age, household education and income, and state) and health-related [child’s insurance status, special health care need status, and past year Indian Health Service (IHS) utilization] characteristics were assessed among AIAN children. Overall, the prevalence of medical home was 27 % lower among AIAN children (42.6, 95 % CI = 34.4–50.8) than NHW children (58.3, 95 % CI = 56.2–60.4). Child’s age (adjusted OR [aOR] = 2.7, 95 % CI = 1.3–5.6) was significantly associated with medical home. IHS utilization was associated with medical home among AIAN children with private insurance (aOR = 0.2, 95 % CI = 0.1–0.4), but not among uninsured or publicly insured children. Care coordination and family-centered care were noted areas for improvement among AIAN children. Less than half of AIAN children had a medical home. Future studies should further examine the intersection between insurance and IHS to determine if enhanced coordination is needed for this population, which is often served by multiple federally-funded health-related programs.

Keywords

Medical homeDisparitiesAmerican IndiansNational Survey of Children’s Health

Supplementary material

10995_2012_990_MOESM1_ESM.doc (42 kb)
Supplementary material 1 (DOC 42 kb)

Copyright information

© Springer Science+Business Media, LLC (outside the USA)  2012

Authors and Affiliations

  • Danielle T. Barradas
    • 1
  • Charlan D. Kroelinger
    • 1
  • Michael D. Kogan
    • 2
  1. 1.Division of Reproductive Health, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaUSA
  2. 2.Maternal and Child Health BureauHealth Resources and Services AdministrationRockvilleUSA