Perinatal Indicator: Medical Home Before Pregnancy

Definition

A medical home is a partnership between patient and provider to ensure continuous primary health care.

It should provide disease prevention and treatment that is patient-centered, coordinated, comprehensive, and culturally appropriate.

Why Does This Matter?

Lack of health insurance is the greatest barrier to a medical home, prior to, and between pregnancies.
Primary care physicians using the patient-centered medical home model interact with women throughout their reproductive lives.
In providing preconception care, they can identify medical, behavioral and social risks to the patient’s health, and can work with
the patient to minimize them.

For further information, please read the LA Best Babies Network Perinatal Scorecard

Medical Home Before Pregnancy by Income in Los Angeles County (2005-2006)

Data from Maternal and Infant Health Assessment (MIHA) 2005-2006 sample

  • In Los Angeles County,  61.9% of women living below the federal poverty level had a medical home prior to pregnancy, the lowest rate among all the groups surveyed, even though theoretically these low-income women qualify for Medi-Cal (suggesting that there might be other barriers to receiving care, such as legal status or cultural/language barriers).
  • Women whose income was 301-400% of the federal poverty level had the highest rate (84.9%) of medical homes prior to pregnancy, even higher than that of women in the next highest income bracket (over 400% of FPL).
  • 16.9% of women whose  income was over 400% of the Federal Poverty Level did not have a medical home prior to their pregnancy.
  • For more information on the Federal Poverty Level and associated income brackets, see: http://aspe.hhs.gov/poverty/index.shtml

 

 Maternal Income as a % of FPL
 
  Medical Home Before Pregnancy
 %  95% CI
 0-100%  61.9  58.1-65.6
 101-200%  69.4  64.7-74.2
 201-300%  79.3  72.5-86
 301-400%  84.9  78.1-91.7
 Over 400%  83.1  79-87.2
 No income information  67.3  60.4-74.2

Sources: Maternal And Infant Health Assessment (MIHA) 2005-2006 sample

 

Resources: the National Center for Medical Home Implementation. This resource is for health professionals, families, and anyone interested in creating a medical home for all children and youth.

National Center for Medical Home Implementation's  Building Your Medical Home Toolkit