Disparities in the National Prevalence of a Quality Medical Home for Children With Asthma

Objective The aim of this study was to examine sociodemographic disparities in having a quality medical home among a nationally representative sample of children with asthma. Methods The study examined data from the 2003 National Survey of Children's Health to identify 8360 children aged 2–17 years with asthma. Risk factors including nonwhite race/ethnicity, income Results Before and after adjustment for demographics and asthma difficulties, most risks except less than high school parent education were related to a poorer quality medical home. Uninsured children had the highest odds of a poorer quality medical home overall (adjusted odds ratio [OR] 5.19, 95% confidence interval [CI] 3.52–7.65) and across most features, except for coordination. Children experiencing 3+ risks had 8.56 times the odds of a poorer quality medical home overall (95% CI 4.95–14.78) versus zero risks. Conclusions This study demonstrates large national disparities in a quality medical home for children with asthma. That disparities were most prevalent for the uninsured (insurance being a modifiable risk factor) suggests increasing coverage is essential to assuring that children obtain a quality medical home.