Article Provides Percentages of Children with Special Health Care Needs Receiving High-Quality Services

January 22, 2011

"This article presents new findings on the degree to which children with special health care needs are receiving high-quality care, as evidenced by the successful attainment of six quality indicators that together can be viewed as representing the essential elements of a system of care," write the authors of an article published in the February 2011 issue of the American Journal of Public Health. Programs addressing the unique needs of children, particularly those at increased risk for or with special health care needs, have long been a component of the public health system. The Maternal and Child Health Bureau has established six quality indicators to describe what families of children with special health care needs (CSHCN) should be able to expect from the service system:

  1. family partnership in decision-making and satisfaction with care,
  2. receipt of care through a medical home,
  3. adequate health insurance,
  4. early and continuous screening and surveillance,
  5. services that are organized for ease of use, and
  6. effective transition planning for adult health care. Together, these quality indicators represent the essential elements needed for a high-quality system of services.

Working with state Title V CSHCN programs, families, and other stakeholders, MCHB developed a monitoring strategy for assessing progress toward attaining the six quality indicators and the systems goal using the National Survey of Children with Special Health Care Needs (NS-CSHCN), a large-scale telephone-based survey of parents of CSHCN. This article presents results from the 2005-2006 NS-CSHCN on the proportion of children for whom each quality indicator is met as well as the proportion for whom all six quality indicators and, hence, a system of services, are in place. State-level estimates are also provided.

The authors found that

  • Quality indicator #1: Criteria for the decision-making and satisfaction quality indicator were met for 57.1 percent of CSHCN during 2005-2006. State success rates for this indicator ranged from 46.6 percent to 65.7 percent.
  • Quality indicator #2: An estimated 47.1 percent of CSHCN had all five components of the medical home quality indicator met during 2005-2006. State success rates for this indicator ranged from 36.9 percent to 57.4 percent.
  • Quality indicator #3: Overall, 62.0 percent of CSHCN had all components of the health insurance quality indicator met during 2005-2006. State success rates for this indicator ranged from 53.5 percent to 73.5 percent.
  • Quality indicator #4: An estimated 63.8 percent of CSHCN had the screening and surveillance indicator met during 2005-2006. State success rates for this indicator ranged from 50.3 percent to 79.9 percent.
  • Quality indicator #5: An estimated 81.1 percent of CSHCN had the ease-of-use quality indicator met during 2005-2006. State success rates for this indicator ranged from 82.6 percent to 94.3 percent.
  • Quality indicator #6: An estimated 41.2 percent of adolescents (ages 12-17) with special health care needs experienced a fully met transition quality indicator during 2005-2006. State success rates for this indicator ranged from 24.0 percent to 54.4 percent.
  • High-quality systems: During 2005-2006, 17.7 percent of CSHCN received care consistent with all quality indicators and could thus be considered as receiving care in a high-quality system.

The authors conclude that "although this assessment documents a degree of success nationally in meeting the quality indicators and to a lesser extent the systems goal, continued and concerted efforts by government and private agencies, health care professionals, and families are needed to ensure that children with special health care needs receive the high-quality care they need."

 

Strickland BB, van Dyck PC, Kogan MD, et al. 2011. Assessing and ensuring a comprehensive system of services for children with special health care needs: A public health approach. American Journal of Public Health 101(2):224-231. Abstract available at http://ajph.aphapublications.org/cgi/content/abstract/101/2/224.

 

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