Racial and Ethnic Disparities among Pediatric Patients at Community Health Centers.

Abstract

To assess racial/ethnic disparities in pediatric utilization of community health centers (CHCs) among a nationally representative sample. Using the 2009 Health Center Patient Survey, a nationally representative sample of CHC patients, demographic characteristics, health conditions, and service utilization were examined for patients under 18 years old (n = 590). Negative binomial and logistic regression models assessed disparities in access to routine care, ambulatory service intensity, and hospital utilization. Racial/ethnic disparities were not present for well-child visits or dental checkups. However, disparities in ambulatory care service intensity and hospital use were observed. Compared with white children, Hispanic children had fewer CHC visits (incidence rate ratio [IRR] 0.62; 95% CI 0.41-0.95), and fewer visits to other ambulatory providers (IRR 0.30; 95% CI 0.15-0.61). Black children had fewer CHC visits (IRR 0.46; 95% CI 0.31-0.70) and fewer visits to other ambulatory providers (IRR 0.23; 95% CI 0.06-0.91), and were also less likely to have been hospitalized (OR 0.04; 95% CI 0.01-0.26). Study limitations included the cross-sectional study design, the self-reported data, and the age of the data. Nevertheless, this study demonstrates that there are fewer disparities among children who visit CHCs in comparison with national trends, but there is still room for improvement. Future initiatives should address remaining challenges in ensuring access to care for all children in underserved communities.