Table 1.
Percentage of children with special health care needs (CSHCN) meeting the criteria for a system of services by the six quality indicators, components and sub-components: US, 2009–2010
| Valid N | National percent
|
Confidence interval 95 % | ||
|---|---|---|---|---|
| (%) | (SE) | |||
| Quality indicator 1: families of CSHCN are partners in decision-making | 39,876 | 70.3 | 0.44 | (69.4–71.1) |
| Doctors usually or always discuss range of optionsa | 40,094 | 81.7 | 0.38 | (81.0–82.5) |
| Doctors usually or always encourage questionsa | 40,044 | 81.4 | 0.38 | (80.6–82.1) |
| Doctors usually or always make it easy to ask questionsa | 40,088 | 86.2 | 0.36 | (85.5–86.9) |
| Doctors usually or always consider and respect family’s choicesa | 40,010 | 84.4 | 0.37 | (83.7–85.1) |
| Quality indicator 2: CSHCN receive care within a medical home | 38,950 | 43.0 | 0.45 | (42.1–43.9) |
| Child has a usual source of care | 40,100 | 89.3 | 0.29 | (88.7–89.9) |
| Child has a usual source for sick care | 40,164 | 90.5 | 0.28 | (90.0–91.0) |
| Child has a usual source for preventive care | 40,167 | 96.7 | 0.17 | (96.3–97.0) |
| Child has a personal doctor or nurse | 40,186 | 93.1 | 0.24 | (92.6–93.6) |
| Child has no problems obtaining referrals when neededb | 13,274 | 76.6 | 0.72 | (75.2–78.0) |
| Child receives effective care coordinationc | 29,845 | 56.0 | 0.53 | (54.9–57.0) |
| Family is very satisfied with doctors’ communication with each otherc,d | 26,415 | 62.7 | 0.55 | (61.6–63.7) |
| Family is very satisfied with doctors’ communication with other programsc | 11,523 | 53.1 | 0.85 | (51.4–54.7) |
| Family usually or always gets sufficient help coordinating care, if neededc | 12,898 | 57.7 | 0.82 | (56.2–59.4) |
| Child receives family-centered carea | 39,685 | 64.6 | 0.46 | (63.7–65.5) |
| Doctors usually or always spend enough timea | 40,032 | 77.5 | 0.41 | (76.7–78.3) |
| Doctors usually or always listen carefullya | 40,073 | 87.7 | 0.34 | (87.0–88.3) |
| Doctors are usually or always sensitive to values and customsa | 39,945 | 88.9 | 0.32 | (88.2–89.5) |
| Doctors usually or always provide needed informationa | 40,058 | 82.4 | 0.38 | (81.6–83.1) |
| Doctors usually or always make the family feel like a partnera | 40,081 | 87.0 | 0.35 | (86.3–87.6) |
| Quality indicator 3: adequate private and/or public insurance | 39,720 | 60.6 | 0.46 | (59.7–61.4) |
| Child had public or private insurance at time of interview | 40,184 | 96.5 | 0.19 | (96.1–96.9) |
| Child had no gaps in coverage during the year before the interview | 40,108 | 90.7 | 0.30 | (90.1–91.3) |
| Insurance usually or always meets the child’s needse | 38,883 | 86.8 | 0.35 | (86.1–87.5) |
| Costs not covered by insurance are usually or always reasonablee | 38,752 | 71.3 | 0.42 | (70.4–72.1) |
| Insurance usually or always permits child to see needed providerse | 38,913 | 89.5 | 0.32 | (88.9–90.1) |
| Quality indicator 4: children are screened early and continuously for special health care needs | 39,877 | 78.6 | 0.39 | (77.8–79.3) |
| Child had a routine preventive medical care visit in past year | 39,990 | 90.4 | 0.27 | (89.8–90.9) |
| Child had a routine preventive dental care visit in past yearf | 39,602 | 85.9 | 0.34 | (85.2–86.5) |
| Quality indicator 5: community-based services are organized so families can use them easily | 39,990 | 65.1 | 0.45 | (64.2–66.0) |
| Child’s family experienced no difficulties or delays getting services | 40,016 | 66.2 | 0.45 | (65.3–67.0) |
| No difficulties or delays due to lack of eligibility for services | 40,151 | 89.2 | 0.33 | (88.5–89.8) |
| No difficulties or delays due to lack of availability of services | 40,162 | 88.8 | 0.32 | (88.1–89.4) |
| No difficulties or delays due to problems with appointments | 40,202 | 82.2 | 0.38 | (81.4–82.9) |
| No difficulties or delays because of issues related to cost | 40,213 | 85.1 | 0.35 | (84.4–85.7) |
| No difficulties or delays due to trouble getting needed information | 40,209 | 91.0 | 0.28 | (90.4–91.5) |
| No difficulties or delays due to other reasonsg | 28,177 | 97.0 | 0.20 | (96.6–97.4) |
| Child’s family was never or only sometimes frustrated when trying to get services for the child | 36,977 | 90.2 | 0.32 | (89.6–90.8) |
| Quality indicator 6: children with special health care needs receive services necessary to make transitions to adult health care | 16,222 | 40.0 | 0.69 | (38.7–41.4) |
| Child receives anticipatory guidance in the transition to adulthoodh | 13,669 | 36.8 | 0.74 | (35.4–38.3) |
| Doctors have discussed shift to adult provider, if necessaryh | 4,606 | 43.9 | 1.36 | (41.2–46.6) |
| Doctors have discussed future health care needs, if necessaryh | 12,359 | 59.0 | 0.83 | (57.4–60.6) |
| Doctors have discussed future insurance needs, if necessaryh | 10,413 | 35.1 | 0.86 | (33.4–36.8) |
| Child has usually or always been encouraged to take responsibility for his/her health care needsh | 17,050 | 78.0 | 0.60 | (76.8–79.1) |
| CSHCN meeting all age appropriate quality indicators | 37,252 | 17.6 | 0.34 | (16.9–18.2) |
Source: author’s analysis of the 2009/2010 National Survey of Children with Special Health Care Needs
Valid n = unweighted sample size with non-missing data
SE standard error
This component was ascertained only for CSHCN with one or more doctor visits during the previous 12 months
This component was ascertained only for CSHCN who needed a referral during the previous 12 months to see a doctor or receive a service
Care coordination was ascertained for CSHCN who used more than one type of health care service during the previous 12 months. Specific types of health care services included routine preventive care; specialty care; preventive dental care; other dental care; prescription medicine; physical, occupational, or speech therapy; mental health care; substance abuse treatment; home health care; eyeglasses or vision care; hearing aids or hearing care; mobility aids; communication aids; durable medical equipment; early intervention services; and special educational services
Communication with other health care professionals is reported only for CSHCN who used specialty care; physical, occupational, or speech therapy; mental health care; substance abuse treatment; and/or home health care during the previous 12 months
Adequacy of insurance was ascertained only for CSHCN with insurance at the time of the interview
Preventive dental care is reported only for CSHCN who were 1 year of age or older at the time of the survey
Difficulties or delays due to other reasons was ascertained only for CSHCN who did not have other reported difficulties or delays
The transition Quality indicator was ascertained for CSHCN who were 12 years of age or older at the time of the survey. Need for anticipatory guidance was assumed if a discussion occurred or the parent indicated that a discussion would have been helpful