KEYWORDS:
medical home; immunization

BACKGROUND:
Continuity of care and a medical home where a patient receives comprehensive care over a long time period is theorized to contribute to better health care. However, the literature associating a medical home with better health or improved immunization rates is sparse and, in some cases, contradictory.

OBJECTIVE(S):
The purpose of this study was to calculate an odds ratio for a reported “medical home,” quantifying the degree to which a medical home was likely to be found among those children up-to-date by 24 months of age.

METHOD(S):
Using stratified random sampling from birth certificates, we conducted a retrospective cohort study of risk factors for Oregon children not having 4 diphtheria-tetanus-pertussis vaccines, 3 polio vaccines and 1 measles-containing vaccine (4:3:1) by the time they were 24 months old.

RESULT(S):
Among 1633 children studied, going to the same clinic or doctor for primary care and immunizations most of the time ("having a medical home") was significantly associated with children having up-to-date (4:3:1) immunizations at 24 months. In multivariate analysis, infants whose parents reported having no medical home were 2.00 (95% CI 1.27, 3.14) times more likely to be missing shots at 24 months of age than were those with a medical home.

CONCLUSIONS(S):
We found a significant association between children having a medical home and up-to-date immunization coverage rates. Further study is needed to explore whether increasing the proportion of children who have a medical home would increase immunization rates

LEARNING OBJECTIVES:
Participants will understand the significance of a medical home and the role it plays in immunization coverage rates.