Date of Defense:
September 20, 2011
Objective: The goal of this study was to determine whether children from immigrant families are receiving care consistent with major components of the medical home model of care.
Methods: We analyzed data from the 2007 National Survey for Children’s Health. Children’s immigrant status was defined as 1st generation immigrant (child not born in US), 2nd generation immigrant (1 or both parents not born in US), or non-immigrant (US born child and parents). We used bivariate and multiple logistic regression analyses to examine differences in parents’ reports of primary care for their child by immigrant status.
Results: Overall, 22% of 1st generation, 44% of 2nd generation, and 63% of non-immigrant children had care consistent with major components of the medical home. Differences persisted after controlling for age, gender, race, ethnicity, family structure, parental education, English language, insurance, poverty level, and overall health of child. First generation children were less likely than non-immigrants to have a medical home (Odds Ratio (OR): 0.41, 95% Confidence Interval (CI) 0.31-0.55), personal provider (OR: 0.47, CI: 0.32-0.68), family centered care (OR: 0.37, CI: 0.28-0.50), comprehensive care (OR: 0.5, CI: 0 .26-0.92), and usual source of care (OR: 0.46, CI: 0.31-0.68). Second generation children were less likely than non-immigrants to have a medical home (OR: 0.75, CI: 0.65-0.86) or family centered care (OR: 0.73, CI: 0.62-0.86).
Conclusion: The majority of 1st and 2nd generation children in the United States do not receive primary care consistent with a medical home.