Perceived access to pediatric primary care by insurance status and race

Alexander N. Ortega, Denice C.L. Stewart, Steven A. Dowshen, Solomon H. Katz

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


The Nemours system of children's clinics in Delaware was designed to offer comprehensive primary care (medical homes), to children regardless of families' abilities to pay for services. Racial and insurance status differences in perceptions of access to the provisions of medical home and differences by the Short Medical Home Index are assessed. A probabilities proportionate to size sampling method was used to randomly select families in nine clinics. A total of 323 caregivers of children ages 6 to 48 months were surveyed. Results suggest that there are minimal differences in perceptions of access to provisions of the medical home concept by insurance status and race in the clinics studied. However, when using a composite measure of medical home, differences in perceptions were found. The results suggest that insurance status and racial differences in perceptions of access remain even when the system is specifically designed to provide medical homes without regard to demographic factors. Future studies should focus on improving patient interactions with clinic personnel to ensure that access to provisions of care are understood by all consumers.

Original languageEnglish (US)
Pages (from-to)481-493
Number of pages13
JournalJournal of Community Health
Issue number6
StatePublished - 2000
Externally publishedYes


  • Child health services
  • Income
  • Insurance
  • Primary health care
  • Race

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health


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