Association of Healthy Home Environments and Use of Patient-Centered Medical Homes by Children of Low-Income Families.
Medicaid agencies have been promoting the patient-centered medical home (PCMH) model. Most caregivers choose physician practices for their children, and we hypothesized that those following healthier childrearing practices are more likely to seek care in a PCMH.



We selected children with public insurance plans (n = 20,801) from the 2011-2012 National Survey of Children's Health. We used generalized ordinal logistic regression with state fixed effects to assess the association between home environments and children's use of PCMHs.



Children living in the healthiest homes were 1.33 times (p = .001) more likely to receive care from the highest level of PCMH. In states with early PCMH implementation, the odds increased to 2.11 times (p = .001).



Our results show a significant, sizeable relationship between healthier home environments and the use of PCMH by children from low-income families. They provide implications for assessing the effect of PCMH use on health outcomes and use patterns.
Xin
X
Hu
Victoria L
VL
Phillips
Laura M
LM
Gaydos
Peter
P
Joski
D000293:Adolescent; D000328:Adult; D002648:Child; D002662:Child Health Services / Q000191:economics / Q000706:statistics & numerical data; D002675:Child, Preschool; D005191:Family Characteristics; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008484:Medicaid / Q000191:economics; D010290:Parents / Q000193:education / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D018802:Patient-Centered Care / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D011203:Poverty / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000191:economics / Q000706:statistics & numerical data*; D012931:Social Environment; D014481:United States / Q000453:epidemiology
Children; Medicaid; home environment; low-income families; patient-centered medical home