Maternal and Child Health Journal

, Volume 16, Supplement 1, pp 6–13 | Cite as

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


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.


Medical home Disparities American Indians National Survey of Children’s Health 



Many thanks to Drs. Deborah Rosenberg, Ph.D., and Kristin Rankin, Ph.D., for their statistical expertise and support, and to Jennifer Irving, M.P.H, for her thoughtful review of this manuscript. The findings and conclusions found in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Supplementary material

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


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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

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