Effect of Patient-Centered Medical Home on Childhood Obesity and Associated Health Disparities in the United States

Objective: “Patient-Centered Medical Home” (PCMH) is an innovative attempt aiming to enhance integrated health services and better patient health outcomes. This study examined PCMH’s effect on obesity status among children and potential racial/ethnic and socioeconomical disparities in PCMH enrollment.

Method: This was a retrospective single-year cross-sectional study. Children aged 10-17 years in the 2011-2012 National Survey of Children’s Health were extracted. The Andersen Model of Health Care Utilization was used as a conceptual framework. Two weighted logistic regressions were conducted to capture the effects of PCMH on children’s obesity and overweight status, and an additional logistic regression was performed to examine potential racial/ethnic and socioeconomical disparities in PCMH enrollment.

Results: Logistic regressions revealed that PCMH had no significant effect on children’s obesity and overweight status. Non-Hispanic white children were more likely to have a PCMH enrollment than Hispanic children (OR=2.42; p < .05). Also, the higher children’s family income was, the more likely children had a PCMH enrollment (OR=1.27 for 100-200% federal poverty level [FPL], OR=1.67 for 200-300% FPL, OR=1.98 for 300-400% FPL compared to children ≤ 100% FPL; all ps < .05).

Conclusions: Although integrated health services such as PCMH were posited to influence children’s overweight and obesity status, the evidence from the 2011-2012 National Survey of Children’s Health did not support such a hypothesis. While more studies are needed to confirm or disconfirm this hypothesis, the finding of this study indicates the need for reducing racial/ethnic and socioeconomical disparities in children’s PCMH enrollment for accessible integrated health services.