Does a Medical Home Buffer the Association between Child Poverty and Poor Health?

Jones, Rebecca; Anyigbo, Chidiogo; Morris, Hannah R.; Tumin, Dmitry; Jamison, Shaundreal

doi:10.1353/hpu.2021.0174

Cited by 5 publications

(3 citation statements)

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“…Lack of access to a medical home may be due to socioeconomic disadvantage, discrimination, rural residence, poor quality of the clinician/family relationship, barriers related to transportation, taking time off work, or limited clinic hours. [11][12][13][14] Whereas prior population-based studies investigating access to a medical home have not considered the role of prematurity, evidence from the 2016-2017 NSCH suggests that VLBW and preterm birth were associated with lower rates of medical home access among children ages 0-5 years. 15 By considering later ages, this study examined whether VLBW and preterm birth were associated with an enduring disadvantage in receiving comprehensive pediatric health care.…”

Section: Discussionmentioning

confidence: 99%

Prematurity, birth weight, and access to a medical home among school-aged children in the US: A cross-sectional survey

Eubanks

Tumin

Peedin

2023

International Journal of Care Coordination

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Introduction Prematurity and low birth weight (LBW) are associated with higher health care needs and higher health care utilization in the first few years of life. The aim of this cross-sectional study was to determine how prematurity and LBW were correlated with access to a medical home later in childhood, at ages 6–17 years. Methods Data were analyzed from the 2016–2018 National Survey of Children's Health. Non-institutionalized US children 6–17 years of age who had been born preterm were classified as very low birth weight (VLBW, <1500 g), LBW (1500–2500 g), and normal weight (NBW, >2500 g). Term-born NBW children were included as a reference group. Medical home access was determined according to caregiver report. Results The analysis included 64,597 infants (preterm VLBW n = 737; preterm LBW n = 2869; preterm NBW n = 3942; and term NBW n = 57,049). Based on this sample, 44% of children ages 6–17 years were estimated to receive care meeting the criteria of a medical home. On multivariable analysis, none of the preterm groups had higher likelihood of receiving care in a medical home compared to children born at term and NBW (odds ratios ranging from 0.75 to 0.95). Conclusions School-aged children born preterm and LBW were equally or less likely to receive care meeting the criteria of a medical home than children born at term and NBW. Although prematurity and LBW are associated with increased health care use early in the life course, this does not appear sufficient to help children establish and maintain access to a medical home.

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Section: Discussionmentioning

confidence: 99%

Prematurity, birth weight, and access to a medical home among school-aged children in the US: A cross-sectional survey

Eubanks

Tumin

Peedin

2023

International Journal of Care Coordination

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“…All analyses accounted for the survey weights, complex sampling design, and use of multiply imputed income data. 15…”

Section: Methodsmentioning

confidence: 99%

Children’s Special Health Care Needs and Caregivers’ Well-Being During the COVID-19 Pandemic

Pasli,

Tumin

2023

J Am Board Fam Med

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Background: Caregivers of children with special health care needs (SHCN) report worse self-rated health when compared with caregivers of children without SHCN and have experienced significant stress during the COVID-19 pandemic. We sought to determine whether COVID-19 pandemic-era declines in well-being among caregivers of children with SHCN were steeper than among caregivers of children without SHCN.Methods: We used 2020 to 2021 (pandemic-era, n ¼ 89,560) and 2018 to 2019 (pre-pandemic, n ¼ 57,927) data from the National Survey of Children's Health. Caregiver-reported physical and mental health outcomes were analyzed using multivariable ordinal logistic regression.Results: The pandemic era was associated with 26% higher odds of reporting worse mental health among caregivers of children with SHCN (95% confidence interval [CI]: 116%, 138%), and 20% higher odds of reporting worse mental health among caregivers of children without SHCN (95% CI: 115%, 126%). The magnitudes of these changes were not significantly different from one another (P ¼ .341).Conclusions: Although caregivers of children with SHCN faced significant burdens and increased stress during the pandemic, decline in self-rated mental health among this group was similar to the trend seen among caregivers of children without SHCN.

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“…Because family income data were multiply imputed, statistical significance of bivariate comparisons for this variable was computed using unadjusted logistic regression. 19 In further analysis, we fit multivariable multinomial logistic regression models of need for specialty mental health care, with "met need" set as the reference category of the outcome variable. We repeated this analysis using alternative specifications of the mental health care measure and a more detailed categorization of respondents' residence, as described above.…”

Section: Methodsmentioning

confidence: 99%

Children's unmet need for mental health care within and outside metropolitan areas

Pasli

Tumin

2022

Pediatrics & Neonatology

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Does a Medical Home Buffer the Association between Child Poverty and Poor Health?

Cited by 5 publications

References 0 publications

Prematurity, birth weight, and access to a medical home among school-aged children in the US: A cross-sectional survey

Prematurity, birth weight, and access to a medical home among school-aged children in the US: A cross-sectional survey

Children’s Special Health Care Needs and Caregivers’ Well-Being During the COVID-19 Pandemic

Children's unmet need for mental health care within and outside metropolitan areas

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