Healthcare Disparities between Children with Developmental Disabilities and Typically Developing Children in Ohio

This article examines the effects of insurance type and Care Consistent with the Patient-Centered Medical Home (CC-PCMH) on health disparities between children with developmental disabilities (DD) and typically developing (TD) children. Data from a stratified random sample of Ohio households were used to compare children with DD (n=419) to TD children (n=7701) on health indicators including health status, utilization, quality, access, and unmet healthcare needs. Children with DD were more likely than TD children to have a fair or poor health status (27.7% vs. 1.1%; P<0.001), have two or more overnight hospitalizations (8.5% vs. 0.7%; P<0.001), experience delayed treatment (10.1% vs. 2.4%; P<0.001), and have one or more unmet healthcare needs (19.6% vs. 5.7%; P<0.001). The impact of insurance type and CC-PCMH on these health disparities was then explored. Although disparities remained when data were stratified by insurance type, Medicaid was associated with fewer difficulties accessing healthcare and fewer unmet healthcare needs for both groups of children. Children with DD who received CC-PCMH were less likely to report having a fair or poor health status than children with DD who did not have that model of care (18% vs. 33.1%; P=0.005). Children with DD who had CC-PCMH experienced less delayed treatment (2.0% vs. 14.5%; P<0.001) and fewer unmet healthcare needs compared to children with DD who did not have that model of care. This study suggests that, in Ohio, Medicaid and CC-PCMH may reduce health disparities, providing potential avenues for achieving health equity for children with DD.