title: Socioeconomic and Racial Disparities in Parental Perception and Experience of Having a Medical Home, 2007 to 2011-2012.
abstract: To evaluate whether socioeconomic (SES) and racial disparities in the parental perception and experience of having a medical home decreased from 2007 to 2011-2012.
  
  
  
  We used nationally representative samples of children aged 1 to 17 from the 2007 (n = 83,293) and 2011-2012 (n = 87,774) National Surveys of Children's Health. Multivariable logistic regression was used to test associations between SES (income, employment, and education) and race/ethnicity to the medical home and its subcomponents (personal doctor or nurse, usual source of care, family-centered care, referrals, care coordination), controlling for a priori identified covariates.
  
  
  
  From 2007 to 2011-2012, fewer children overall had access to a medical home (56.9% vs 54.0%, aOR = 0.91, 95% confidence interval 0.86-0.96). There were no significant changes in SES and racial trends in access to the medical home during this time period. For example, parents of children <100% federal poverty level (FPL) were significantly less likely to report having a medical home than parents of children ≥400% FPL in 2007 and 2011-2012; however, this disparity did not significantly change during the time period (aOR = 0.98, 95% confidence interval 0.75-1.27). There were also no significant changes in SES and racial/ethnic disparities over time for each medical home subcomponent.
  
  
  
  Despite widespread efforts to promote the medical home for all children, large SES and racial disparities in the parental perception and experience of having a medical home persisted from 2007 to 2011-2012.
authors.affiliation: Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, Mass. Electronic address: kyang@bu.edu.
authors.forename: Kristen
authors.initials: K
authors.lastname: Diao
authors.affiliation: Department of Biostatistics, Boston University School of Public Health, Boston, Mass.
authors.forename: Yorghos
authors.initials: Y
authors.lastname: Tripodis
authors.affiliation: Department of Pediatrics, University of Massachusetts Memorial Medical Center, Worcester, Mass.
authors.forename: Webb E
authors.initials: WE
authors.lastname: Long
authors.affiliation: Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, Mass.
authors.forename: Arvin
authors.initials: A
authors.lastname: Garg
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D001294:Attitude to Health / Q000208:ethnology*; D002648:Child; D002675:Child, Preschool; D004522:Educational Status; D004651:Employment; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000208:ethnology / Q000706:statistics & numerical data; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D007223:Infant; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010290:Parents; D018802:Patient-Centered Care; D010465:Perception; D012923:Social Class; D014481:United States; D044465:White People / Q000706:statistics & numerical data
keywords: children; health care access; health policy; medical home; racial disparities; socioeconomic status