Medical Home Model and Health Disparity Nursing Research Proposal

Medical Home Model and Health Disparity

Nursing Research Proposal

The Impact of the Medical Home Model on Health Disparities

The Impact of the Medical Home Model on Healthcare Disparity

Medical homes are primary care practices where a physician or NP establishes a long-term care relationship with patients and provide patient/family-centered, coordinated, and culturally-sensitive care (AANP, n.d.; Strickland, Jones, Ghandour, Kogan, & Newacheck, 2011). The benefits include improved healthcare access, quality, and safety. A number of states have enacted statutes supporting the medical home model after research findings revealed health disparities for racial and ethnic minorities were reduced (NCSL, 2013).

As a nurse practitioner I am interested in how effective a medical home model would be in reducing healthcare disparities, especially for racial and ethnic minority children residing in underserved communities. Nurse practitioners have traditionally practiced in underserved communities and will continue to do so; therefore, any strategy that could improve the quality of care with little or no additional cost would be of great interest to me and my patients. To better understand how a medical home model can reduce health disparities this essay will review the findings of recent research studies on this topic.

The Medical Home Model and Minority Children

Toomey and colleagues (2013) began by discussing the importance of care coordination for improving healthcare access and quality, lowering costs, and increasing provider satisfaction. This justified their investigation of a possible causal relationship between a child's racial identity and experiencing an unmet need for care coordination. The other independent variables they examined included socioeconomic status, personal provider, and family-centered care, with the latter two variables having been associated empirically with better care quality. They used the 2007 National Survey for Children's Health data to answer their questions, which included information from parents of 91,642 children residing in all 50 states and the District of Columbia. The prevalence of unmet care coordination need was 27, 38, and 40% for White, Black, and Latino children, respectively. Other predictors of unmet need were single parent households, low-income, non-English-speaking households, public insurance, no insurance, and the absence of a personal healthcare provider. In addition, children with special health care needs (CSHCNs) were more than twice as likely to have experienced an unmet need for care coordination compared to other children. Personal providers improved the chances of a minority child having access to coordinated care, but the level of health disparity was not significantly changed. In contrast, minority children with access to family-centered care were significantly less likely to experience an unmet need for coordinated care. These findings suggest that the family-centered component of medical homes can help reduce racial disparities in access to coordinated care.

Bennett and colleagues (2012)…