Association of Medical Home Care and Disparities in Emergency Care Utilization Among Children With Special Health Care Needs

Jean L. Raphael, Yiqun Zhang, Hao Liu, Carl D. Tapia, Angelo P. Giardino

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Objective: The aim of this study was to determine whether having a medical home is associated with a reduction of racial/ethnic disparities in emergency care utilization by children with special health care needs (CSHCN). Methods: We conducted a secondary analysis of 35 301 children, aged 0 to 17, from the 2005-2006 National Survey of Children with Special Health Care Needs. The primary dependent variable was emergency care utilization, defined as 1 or more emergency care encounters in the last 12 months. The primary independent variables were race/ethnicity and type of care (medical home, usual source of care, no medical home/no usual source of care). Multiple logistic regression was conducted to investigate associations between race/ethnicity, type of care, and emergency care utilization. Results: Analysis of type of care and its interactions with race/ethnicity showed that non-Hispanic black children with a medical home had higher odds (odds ratio [OR] 1.26, 95% confidence interval [CI] 1.03-1.54) of emergency care utilization compared with non-Hispanic white children with a medical home. The odds of having 1 or more emergency care visits were higher for non-Hispanic black children (OR 1.38, 95% CI 1.22-1.56) compared with non-Hispanic white children after controlling for sociodemographic variables. Having a medical home was associated with lower odds of emergency care utilization (OR 0.81, 95% CI 0.72-0.90) compared with having neither a medical home nor a usual source of care. Conclusions: Emergency care utilization for CSHCN differed significantly according to race/ethnicity. Having a medical home may be associated with a reduction in disparities in this fragile population.

Original languageEnglish (US)
Pages (from-to)242-248
Number of pages7
JournalAcademic Pediatrics
Volume9
Issue number4
DOIs
StatePublished - Jul 1 2009
Externally publishedYes

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Patient-Centered Care
Emergency Medical Services
Home Care Services
Delivery of Health Care
Odds Ratio
Confidence Intervals
Logistic Models

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Association of Medical Home Care and Disparities in Emergency Care Utilization Among Children With Special Health Care Needs. / Raphael, Jean L.; Zhang, Yiqun; Liu, Hao; Tapia, Carl D.; Giardino, Angelo P.

In: Academic Pediatrics, Vol. 9, No. 4, 01.07.2009, p. 242-248.

Research output: Contribution to journalArticle

Raphael, Jean L. ; Zhang, Yiqun ; Liu, Hao ; Tapia, Carl D. ; Giardino, Angelo P. / Association of Medical Home Care and Disparities in Emergency Care Utilization Among Children With Special Health Care Needs. In: Academic Pediatrics. 2009 ; Vol. 9, No. 4. pp. 242-248.
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