According to the American Academy of Pediatrics, children’s medical care should be accessible, family-centered, continuous, comprehensive, coordinated, compassionate, and culturally effective. These characteristics of high-quality health care can be combined into the concept of the medical home. The 2007 National Survey of Children’s Health made an effort to measure whether children’s health care is meeting the medical home standard. For this purpose, the survey included questions on the following: 1) whether the child has at least one personal doctor or nurse and a usual source of sick care; 2) whether the child has no problems gaining referrals to specialty care and access to therapies or other services or equipment; 3) whether the family is very satisfied with the level of communication among their child’s doctors and other programs; 4) whether the family usually or always gets sufficient help coordinating care when needed, and receives effective care coordination; 5) whether the child’s providers usually or always spend enough time with the family, listen carefully to concerns, are sensitive to values and customs, provide needed information, and make the family feel like a partner in the child’s care; and 6) whether an interpreter is usually or always available when needed. If a child’s care met all of these criteria, according to the parent, then the child was defined as having a medical home.
Overall, the care received by 57.5 percent of children met this medical home standard. This varied substantially by race and ethnicity: 68.0 percent of non-Hispanic White children received care from a medical home, compared to 63.0 percent of multiracial children, 44.2 percent of non-Hispanic Black children, 38.5 percent of Hispanic children, and 48.6 percent of children of other races.
Receipt of care from a medical home also varied by insurance status. Children with private insurance were most likely to receive care from a medical home (66.5 percent), followed by children with public insurance (45.4 percent). Children who were not currently insured were least likely to have a medical home (35.7 percent).