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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Kenneth D. Rosenberg, MD, MPH, Office of Family Health, Oregon Division of Human Services, 800 NE Oregon Street, Suite 850, Portland, OR 97232, 503-731-4507, ken.d.rosenberg@state.or.us, Nathan E. Crawford, MPH, Office of Family Health, Oregon Department of Human Services, 800 NE Oregon Street, Suite 370, Portland, OR 97232, and Shannon R. Siegel, PhD, School of Sport, PE and Recreation, University of Wales Institute, Cardiff; Cyncoed Campus, Cyncoed Road, Cardiff, CF23 6XD, United Kingdom.
INTRODUCTION: Only recently have researchers begun to explore the health consequences of children having a medical home (including comprehensive and continuous care). The literature associating medical homes with better health is sparse and, in some cases, contradictory. The purpose of this study was to explore the association between a reported medical home and childhood immunization status in a retrospective cohort.
METHODS: On November 1, 1996, a stratified random sample of 3149 Oregon births between 19-35 months of age (DOB 11/1/93-4/1/95) was selected. 80.4% (2452/3048) of the sample's families were interviewed and their immunization histories verified. Those with a medical home "went to the same clinic or doctor for primary care and immunizations most of the time." We had information on medical home and immunization through 24 months on 1703 children. Responses were weighted for survey design and nonresponse. The outcome variable was up-to-date immunization (4 DTP, 3 Polio, 1 measles-containing vaccine) at 24 months by November 1, 1996.
RESULTS: 90.5% of children had a medical home. Using multivariate logistic analysis, we found that infants whose parents reported having no medical home were 2.00 (95% CI 1.27, 3.14) times more likely to be not up-to-date at age 24 months than those with a medical home.
DISCUSSION: In this study, infants with a medical home were significantly more likely to have up-to-date immunizations before their third birthday than children without a medical home. This finding may not contradict two other studies of medical homes and up-to-date immunization. As researchers operationalize medical home, it will be important for researchers and readers to understand the various definitions of medical home.
Learning Objectives:
Keywords: Immunizations, Medical Care
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.