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Poverty and InequalitySexual and Reproductive HealthFamily, Maternal & Child HealthMethodology

Care coordination for CSHCN: associations with family-provider relations and family/child outcomes

TitleCare coordination for CSHCN: associations with family-provider relations and family/child outcomes
Publication TypeJournal Article
Year of Publication2009
AuthorsTurchi, RM, Berhane, Z, Bethell, C, Pomponio, A, Antonelli, R, Minkovitz, CS
JournalPediatrics
Volume124 Suppl 4
PaginationS428-34
Date PublishedDec
ISBN Number0031-4005
Accession Number19948609
Keywords*Physician-Patient Relations, Absenteeism, Adolescent, Ambulatory Care/statistics & numerical data, Child, Child, Preschool, cost of illness, Disabled Children/*statistics & numerical data, Educational Status, Emergency Medical Services/utilization, Employment/statistics & numerical data, Family Nursing/utilization, Family Practice/*organization & administration, Female, Health Services Needs and Demand/statistics & numerical data, Health Status, Humans, Income/statistics & numerical data, Infant, Infant, Newborn, Insurance, Health/statistics & numerical data, Logistic Models, Male, Multivariate Analysis, Organization and Administration, Outcome Assessment (Health Care)/*statistics & numerical data, Patient Satisfaction/statistics & numerical data, United States
Abstract

OBJECTIVE: To examine the association between receiving adequate care coordination (CC) with family-provider relations and family/child outcomes. METHODS: We analyzed data from the 2005-2006 National Survey of Children With Special Health Care Needs. Eligible subjects were the 88% of families asked about experience with CC, service use, and communication. Respondents also reported on demographic characteristics, health status, family-provider relations, and family/child outcomes. Weighted, multivariate logistic regression models were constructed to assess independent associations of adequate CC with outcomes. RESULTS: Among families with children with special health care needs asked about CC, 68.2% reported receiving some type of CC help. Of these, 59.2% reported receiving adequate CC help, and 40.8% reported inadequate CC. Families that reported adequate compared with inadequate CC had increased odds of receiving family-centered care, experiencing partnerships with professionals, and satisfaction with services. They had decreased odds of having problems with referrals for specialty care, missing >6 school days because of illness (previous year), and visiting the emergency department more than twice in the previous 12 months (P < .001). Those who reported adequate compared with inadequate CC had decreased odds of the following: more than $500/y of out-of-pocket expenses, family financial burden, spending more than 4 hours/week coordinating care, and stopping/reducing work hours. CONCLUSIONS: Parental report of adequate CC was associated with favorable family-provider relations and family/child outcomes. Additional efforts are needed to discern which aspects of CC are most beneficial and for which subgroups of children with special health care needs.