Medical Home Disparities Are Not Created Equal: Differences in the Medical Home for Children from Different Vulnerable Groups

Objective. To identify components of the medical home that contribute to medical home disparities for vulnerable children. Methods. Cross-sectional analysis of 2007 National Survey of Children’s Health. Prevalence of components of the medical home were estimated by special health care needs (SHCN), race/ethnicity, primary language, and health insurance. Results. Medical home disparities for children with SHCN were driven by differences in getting help with care coordination, when needed (71% vs. 91% children without SHCN, p<.001). Medical home disparities for other groups were largely attributable to less family-centered care (Hispanic 49% and African American 55% vs. White 77%, p<.001; non-English primary language 37% vs. English 72%, p<.001; uninsured 45% and publicly insured 57% vs. privately insured 75%, p<.001). Conclusions. The components of the medical home that contribute to medical home disparities differ between groups of vulnerable children. Medical home implementation may benefit from focusing on the specific needs of target populations.