Children with special healthcare needs (CSHCN) experience a greater burden of emotional, physical, and financial stress than children without special health care needs. The United States Department of Health and Human Services Healthy People 2020 goals include an objective to increase access to a medical home by CSHCN. Studies using data from national surveys reveal a positive association in access to a medical home and increased use of healthcare services, lower out of pocket costs, and less delayed or forgone care. However, when CSHCN of color are compared to white CSHCN, disparities in outcomes continue to exist even in the presence of a medical home. The objective of this study is to assess perceived attributes of and overall experience with primary care in children with and without special health care needs. A cross-sectional survey was conducted with consecutive, English speaking caregivers in eight pediatric practices in Grand Rapids, Michigan. CSHCN were more likely to be male, over 5 years of age, and in poor health compared to children without special health care needs. There was no association between special health care need status and experience of care within a medical home. However, non-white race was the only demographic variable associated with both specific domains and the overall scores of primary care. While the study suffered from potential biases, the results confirm similar findings in nationally representative surveys of parents of racial disparities in experience of primary care and presence of a medical home. -- Abstract.
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