Medical Home Access Among American Indian and Alaska Native Children in 7 States: National Survey of Children’s Health
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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.
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- Medical Home Access Among American Indian and Alaska Native Children in 7 States: National Survey of Children’s Health
Maternal and Child Health Journal
Volume 16, Issue 1 Supplement, pp 6-13
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Medical home
- American Indians
- National Survey of Children’s Health
- Industry Sectors
- Author Affiliations
- 1. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS K-22, Atlanta, GA, 30341, USA
- 2. Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD, USA