title: Patient Centered Medical Home Care Among Near-Old and Older Race/Ethnic Minorities in the US: Findings from the Medical Expenditures Panel Survey.
abstract: Access to Patient Centered Medical Home (PCMH) care has not been explored among older racial/ethnic minorities. We used data on adults 55-years and older from the Medical Expenditure Panel Survey (2008-2013). We account for five features of PCMH experiences and focus on respondents self-identifying as Non-Latino White, Black, and Latino. We used regression models to examine associations between PCMH care and its domains and race/ethnicity and decomposition techniques to assess contribution to differences by predisposing, enabling and health need factors. We found low overall access and significant racial/ethnic variations in experiences of PCMH. Our results indicated strong deficiencies in access to a personal primary care physician provided healthcare. Factors contributing to differences in reported PCMH experiences relative to Whites differed by racial/ethnic grouping. Policy initiatives aimed at addressing accessibility to personal physician directed healthcare could potentially reduce racial/ethnic differences while increasing national access to PCMH care.
authors.affiliation: Institute of Gerontology, Wayne State University, 87 East Ferry Street, Detroit, MI, 48202, USA. wassim.tarraf@wayne.edu.|Department of Healthcare Sciences, Eugene Appelbaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, USA. wassim.tarraf@wayne.edu.
authors.forename: Wassim
authors.initials: W
authors.lastname: Tarraf
authors.affiliation: Institute of Gerontology, Wayne State University, 87 East Ferry Street, Detroit, MI, 48202, USA.|Department of Economics, Wayne State University, Detroit, USA.
authors.forename: Gail
authors.initials: G
authors.lastname: Jensen
authors.affiliation: Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, USA.
authors.forename: Hector M
authors.initials: HM
authors.lastname: González
mesh_terms: D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006304:Health Status; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data; D018802:Patient-Centered Care / Q000706:statistics & numerical data*; D058007:Physicians, Primary Care / Q000706:statistics & numerical data*; D044469:Racial Groups / Q000706:statistics & numerical data*; D014481:United States; D044465:White People
keywords: Healthcare quality; PCMH; Primary care; Racial/ethnic disparities