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APHA Scientific Session and Event Listing

Recorded presentation

Mary Beth Zeni, ScD¹, Dan R. Thompson, MPH¹, and Michael D. Kogan, PhD². (1) School of Nursing, Florida State University, 413 Duxbury Hall, Tallahassee, FL 32306, 850-644-5355, mzeni@nursing.fsu.edu, (2) Office of Data and Program Development, HRSA/ Maternal and Child Health Bureau, 5600 Fishers Lane, Room 18-41, Rockville, MD 20857

Analysis of federal population-based datasets provides an evidence-based method for community health planning and policy development. The authors will present findings from a study analyzing the 2003-2004 National Survey of Children's Health, a nationally-representative study of 102,000 children that can also provide state-level estimates. The study examined US children at risk for lacking a medical home. The concept of ‘medical home' is important in providing consistent and comprehensive preventive care to children and care coordination for children with chronic conditions. Little work has been conducted regarding which groups are at higher risk for lacking a medical home. Medical home was derived from 8 questions based on the American Academy of Pediatrics definition. 53.9% of US children lack a medical home. Logistic regression analysis found that the odds of lacking a medical home were significantly increased for parental assessment of child's health status as good (1.39) and fair or poor (1.28) (versus excellent/very good), age 1- 4 (1.68), age 5-12 (2.79), age 13-17 (3.38) (reference for age is age < 1), Hispanics (1.25), primary household language Spanish (1.87), Blacks (1.28), below 100% poverty level (1.93), poverty 100-200% (1.60), poverty 200-400% (1.24), household education less than high school (1.31), and moderate-severe emotional/behavioral condition (1.51). Health insurance and being in a 2 parent family reduced the risk of lacking a medical home. Findings from Florida will be compared to provide an example of state-level data. Factors besides health status need to be considered to achieve comprehensive health care for children.

Learning Objectives:

• Discuss the use of the National Survey of Children's Health as a methodological technique to support evidence-based community health planning and policy development.
• Articulate the major components of the concept 'medical home'.
• Identify factors associated with US children not having a medical home.

Keywords: Access to Health Care, Children and Adolescents

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation