Racial Health Disparities Among Special Health Care Needs Children With Mental Disorders: Do Medical Homes Cater to Their Needs?

Background: A health care reform has been taking place to provide cost-effective and coordinated care. One method of achieving these goals is a patient-centered medical home (PCMH) model, which is associated with provision of quality care among children belonging to racial/ethnic minorities. Despite the potential of the PCMH for children of minority backgrounds, little is known about the extent to which minorities with mental disorders have the PCMH. Objective: The study examined racial/ethnic disparities among children with mental disorders in accessing care from the PCMH. Methods: The 2009-2010 National Survey of Children with Special Health Care Needs (CSHCN) was used for this analysis. Multivariate logistic regressions were applied to capture the racial/ethnic disparities and to analyze a composite outcome of the PCMH. Results: An estimated population size of 4 677 904 CSHCN with mental disorders was included. Among them, 59.94% of children reported to have received medical homes. Compared with white children, the odds of receiving any medical home services decreased among Hispanic children (odds ratio [OR] = 0.69; P <.05) and black children (OR = 0.70; P <.05). The likelihood of having a medical home was lower for Hispanic children than white children, when they had attention deficit hyperactivity disorder (ADHD; OR = 0.57; P <.05) and development delay (OR = 0.73; P <.05). Compared with white children with ADHD or depression having a medical home, the odds of black children with ADHD (OR = 0.63; P <.05) and depression (OR = 0.68; P <.05) having a medical home were lower. Conclusions: There were significant racial/ethnic disparities among CSHCN with mental disorders, indicating several sizeable effects of each of the 5 components on Hispanic, black, and other children compared with white children. These differences could be a potential to improve racial/ethnic disparities.