Disparities in Provider Elicitation of Parents' Developmental Concerns for US Children
Disparities in Provider Elicitation of Parents' Developmental Concerns for US Children
复制标题
DOI：
10.1542/peds.2011-0030
复制
发表时间：
2011-11-01
期刊：
影响因子：
8
通讯作者：
Flores, Glenn
中科院分区：
文献类型：
--
作者：
Guerrero, Alma D.;Rodriguez, Michael A.;Flores, Glenn
目的：为了研究与供应商引出的父母的发展concerns among US children.METHODS：2007年全国儿童健康调查的相关因素被用来研究与父母的报告提供商引出的发展问题在过去的12个月。自变量包括儿童特征，社会人口因素，保险状况，并有一个医疗home.RESULTS：一半的美国父母报告供应商引出的发展问题。非洲裔美国人（41%）和拉丁美洲人（49%的家庭以英语为主要语言，33%的家庭以非英语为主要语言）的父母比白色父母（55%）报告发展问题的可能性要小得多。经多变量校正后，与白色父母相比，非裔美国人（比值比[OR]：0.67 [95%置信区间[CI]：0.55-0.81]）和拉丁美洲人（OR：0.61 [95% CI：0.44-0.84]）父母的供应商引发发育问题的校正比值明显较低。缺乏保险（或：0.61 [95%CI：0.44-0.85]）和拥有医疗之家（OR：1.42 [95%CI：1.21-1.67]）与引发发育问题相关。接受以家庭为中心的护理的非裔美国人和拉丁裔儿童的父母几乎是提供者诱导的两倍。对于拉丁裔父母在家庭与非英语的主要语言，其他医疗家庭组件，包括有一个个人提供者（OR：1.51 [95% CI：1.08-2.11]）和常规护理来源（OR：1.76 [95%CI：1.13-2.74]），与发育问题的诱发显著相关。在提供者提出发展关切方面存在种族/族裔和语言差异。解决缺乏保险、医疗之家和特定医疗之家组成部分的问题可能会减少差距。儿科2011; 128：901-909
OBJECTIVE: To examine factors associated with provider elicitation of parents' developmental concerns among US children.METHODS: The 2007 National Survey of Children's Health was used to examine factors associated with parents' reports of provider elicitation of developmental concerns in the previous 12 months. Independent variables included child characteristics, sociodemographic factors, insurance status, and having a medical home.RESULTS: One-half of US parents reported provider elicitation of developmental concerns. African-American (41%) and Latino (49% in households with English as the primary language and 33% with a non-English primary language) parents were significantly less likely than white parents (55%) to report elicitation of developmental concerns. With multivariate adjustment, African-American (odds ratio [OR]: 0.67 [95% confidence interval [CI]: 0.55-0.81]) and Latino (OR: 0.61 [95% CI: 0.44-0.84]) parents, compared with white parents, had significantly lower adjusted odds of provider elicitation of developmental concerns. Lack of insurance (OR: 0.61 [95% CI: 0.44-0.85]) and having a medical home (OR: 1.42 [95% CI: 1.21-1.67]) were associated with elicitation of developmental concerns. Parents of African-American and Latino children who received family-centered care had almost twice the odds of provider elicitation. For Latino parents in households with a non-English primary language, other medical home components, including having a personal provider (OR: 1.51 [95% CI: 1.08-2.11]) and a usual source of care (OR: 1.76 [95% CI: 1.13-2.74]), were significantly associated with elicitation of developmental concerns.CONCLUSIONS: Racial/ethnic and linguistic disparities exist in provider elicitation of developmental concerns. Addressing lack of insurance, medical homes, and specific medical-home components might reduce disparities. Pediatrics 2011; 128: 901-909