Table 4.
Multilevel regression models estimating the association between a medical home and individual- and state-level covariates for children with public and private insurance, 2007
| Public
|
Private
|
|||||
|---|---|---|---|---|---|---|
| Model 1: “empty’’ model | Model 2: individual-level covariates | Model 3: individual- and state-level covariates | Model 1: “empty’’ model | Model 2: individual-level covariates | Model 3: individual- and state-level covariates | |
| Measures of variation | ||||||
| State-level variance (SE) | 0.075 (0.031) | 0.025 (0.006) | 0.021 (0.006) | 0.027 (0.005) | 0.020 (0.006) | 0.012 (0.004) |
| Proportional change in variance | −67 % | −16 % | −26 % | −39 % | ||
| Median odds ratio (95 % CI) | 1.30 (1.12–1.42) | 1.16 (1.11–1.20) | 1.15 (1.09–1.19) | 1.17 (1.13–1.20) | 1.14 (1.09–1.19) | 1.11 (1.06–1.14) |
| Individual covariates (OR, 95 % CI) | ||||||
| Child age, years | ||||||
| 0–5 | Ref | Ref | Ref | Ref | ||
| 6–11 | 0.77 (0.70–0.85) | 0.76 (0.69–0.84) | 0.72 (0.67–0.77) | 0.72 (0.67–0.77) | ||
| 12–17 | 0.70 (0.64–0.76) | 0.69 (0.64–0.75) | 0.62 (0.59–0.66) | 0.62 (0.59–0.66) | ||
| Race/ethnicity | ||||||
| White, non-Hispanic | Ref | Ref | Ref | Ref | ||
| African-American, non-Hispanic | 0.47 (0.41–0.54) | 0.48 (0.41–0.55) | 0.57 (0.51–0.63) | 0.57 (0.51–0.63) | ||
| Hispanic | 0.62 (0.52–0.74) | 0.62 (0.51–0.75) | 0.75 (0.66–0.84) | 0.76 (0.67–0.85) | ||
| Multi/other | 0.63 (0.53–0.75) | 0.63 (0.53–0.75) | 0.69 (0.63–0.77) | 0.70 (0.63–0.77) | ||
| Non-English primary language | 0.41 (0.34–0.50) | 0.42 (0.34–0.52) | 0.39 (0.34–0.46) | 0.39 (0.34–0.46) | ||
| Special health care need | 0.70 (0.63–0.78) | 0.70 (0.63–0.78) | 0.60 (0.57–0.64) | 0.60 (0.57–0.64) | ||
| Gap in insurance | 0.67 (0.57–0.79) | 0.67 (0.57–0.79) | 0.61 (0.57–0.64) | 0.61 (0.53–0.71) | ||
| Household income | ||||||
| >400 % FPL | Ref | Ref | Ref | Ref | ||
| 200–399 % FPL | 1.15 (0.97–1.35) | 1.13 (0.95–1.33) | 0.85 (0.80–0.91) | 0.85 (0.80–0.91) | ||
| 100–199 % FPL | 1.04 (0.85–1.28) | 1.04 (0.84–1.28) | 0.72 (0.67–0.77) | 0.72 (0.67–0.77) | ||
| 0–99 % FPL | 0.93 (0.77–1.12) | 0.91 (0.75–1.11) | 0.51 (0.45–0.59) | 0.51 (0.45–0.59) | ||
| Parental education | ||||||
| >High school | Ref | Ref | Ref | Ref | ||
| High school/equivalent | 0.79 (0.72–0.86) | 0.78 (0.71–0.86) | 0.79 (0.73–0.84) | 0.79 (0.73–0.84) | ||
| <High school | 0.66 (0.59–0.75) | 0.66 (0.59–0.75) | 0.59 (0.51–0.69) | 0.59 (0.51–0.69) | ||
| Family structure | ||||||
| Two parents | Ref | Ref | Ref | Ref | ||
| Single mother | 0.91 (0.81–0.99) | 0.90 (0.81–1.00) | 0.82 (.076–0.89) | 0.82 (.076–0.89) | ||
| Other | 0.70 (0.62–0.79) | 0.71 (0.63–0.81) | 0.63 (0.55–0.71) | 0.63 (0.55–0.71) | ||
| State covariates (OR, 95 % CI) | ||||||
| Non-English primary language, %a | 1.00 (0.99–1.00) | 0.99 (0.98–1.00) | ||||
| Minority race/ethnicity, %a | 1.00 (0.99–1.00) | 1.00 (0.99–1.00) | ||||
| PCPs per 100,000 childrena | 1.02 (0.97–1.07) | 0.99 (0.96–1.02) | ||||
| Medicaid-to-Medicare payment ratioa | 0.97 (0.92–1.03) | NA | ||||
| Medicaid enrollees in managed care, %a | 1.00 (0.96–1.04) | NA | ||||
| Individuals with income <200 % FPL served by CHCs, %a | 0.97 (0.92–1.03) | NA | ||||
| HMO penetration (overall market), %a | NA | 1.00 (1.00–1.00) | ||||
Bold text indicates statistical significance, p < 0.05
CHCs community health centers, FPL federal poverty level, PCPs primary care providers
a
Odds associated with an increase of one standard deviation