A number of characteristics of high-quality health care for children can be combined into the concept of the medical home. As defined by the American Academy of Pediatrics, children’s medical care should be accessible, family-centered, continuous, comprehensive, coordinated, compassionate, and culturally effective. A child’s health care was considered to meet this standard if:
- The child has at least one personal doctor or nurse who knows him or her well and a usual source of sick care
- The child has no problems gaining referrals to specialty care and access to therapies or other services or equipment
- The family is very satisfied with the level of communication among their child’s doctors and other programs
- The family usually or always gets sufficient help coordinating care when needed and receives effective care coordination
- The child’s doctors usually or always spend enough time with the family, listen carefully to their concerns, were sensitive to their values and customs, provide any information they need, and make the family feel like a partner in their child’s care.
A child is defined as having a medical home if his or her care was reported to meet all of these criteria. Overall, the care of 54.4 percent of children met this standard, and this percentage did not vary across urban and rural locations.
The proportion of children in each racial and ethnic group with a medical home did not vary significantly across locations. However, within each location, differences between groups were evident: non-Hispanic Black, Hispanic, and children of multiple or other races in all locations were significantly less likely than non-Hispanic White children to have received care from a medical home.
In all locations, uninsured children were least likely to receive care from a medical home, followed by those with public insurance, while children with private insurance were most likely to have a medical home. Among those with public insurance, urban children were less likely than children in rural areas to have a medical home (42.5 percent compared to more than 50 percent). The percentage of privately insured children who had a medical home did not vary significantly by location.