ANN ARBOR, Mich. Children with public insurance are 22 percent less likely to receive comprehensive primary care than those with private insurance, according to new research from the University of Michigan Medical School.
Public insurance programs cover one-third of U.S. children, many of whom belong to the most vulnerable groups, including minorities, the underprivileged and those in poor health. This includes children covered by Medicaid and the Children's Health Insurance Program (CHIP).
The study, available online ahead of print in Academic Pediatrics, determined how often children with public health insurance reported having a 'medical home,' a model for pediatric primary care endorsed by the American Academy of Pediatrics (AAP).
The medical home approach, which is heavily promoted across the country, is designed to facilitate partnerships between patients, parents and care providers. According to the AAP, a medical home is "accessible, continuous, comprehensive, family centered, coordinated, compassionate, and culturally effective." It is often touted as a method of providing excellent pediatric primary care.
Researchers analyzed data from the 2007 National Survey of Children's Health phone survey of households with children ages 0-17, which was conducted by the National Center for Health Statistics. To determine whether they were getting medical home services, the survey asked parents about their child's usual source of care, familiarity with a personal doctor/nurse, difficulty of obtaining referrals, access to family centered care and communication between care providers.
Only 45 percent of children with public insurance met all five of these components, far less than the 67 percent of children with private insurance.
"Because of their vulnerabilities, children with public insurance are a prime target for efforts to promote the medical home," says Joseph S. Zickafoose, M.D., Clinical Lectu
|Contact: Lauren McLeod|
University of Michigan Health System