Association of experiences of medical home quality with health-related quality of life and school engagement among Latino children in low-income families

Abstract

Objective: This study examines whether patient-reported indicators of a quality medical home are associated with measures of health among Latino children in low-income families.

Data sources: Data on 3,258 children ages 2-18 years are from a cross-sectional survey of parents of children affiliated with California's Healthy Kids insurance.

Study design: Medical home quality was assessed using the Parents' Perception of Primary Care and was associated with health-related quality of life (HRQOL) overall and in four domains (physical, emotional, social, and school/daycare) and four measures of school engagement.

Principal findings: A higher total medical home score was associated with a higher total Pediatric Quality of Life Inventory score and scores in four subdomains (total beta [B]=1.77, physical B=1.71, social B=1.36, emotional B=2.22, and school/daycare B=1.69, all p<0.001). It was also associated with missing fewer than three school days due to illness (odds ratio [OR]=1.12, 95 percent confidence intervals [CI]: 1.05, 1.19), excellent/above average school performance overall (OR=1.10, 95 percent CI: 1.03, 1.17) and performance in reading (OR=1.13, 95 percent CI: 1.06, 1.20) and math (OR=1.10, 95 percent CI: 1.03, 1.16).

Conclusions: Patient-reported medical home quality indicators are favorably associated with HRQOL and measures of school engagement among Latino children in low-income families.

Figure 1

Stratified Analysis of Total Medical Home Quality Score on Pediatric Quality of Life Inventory (PedsQL) Total Score Note: Values on the y-axis are regression beta coefficients for the interaction term of total medical home quality with each of the population subgroups. Results are adjusted for all of the study covariates and county.