Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Feb;19(2):353-61.
doi: 10.1007/s10995-014-1517-9.

Assessing systems quality in a changing health care environment: the 2009-10 national survey of children with special health care needs

Bonnie B Strickland  1 , Jessica R Jones, Paul W Newacheck, Christina D Bethell, Stephen J Blumberg, Michael D Kogan
Affiliations

Assessing systems quality in a changing health care environment: the 2009-10 national survey of children with special health care needs

Bonnie B Strickland et al. Matern Child Health J. 2015 Feb.

Abstract

To provide a national, population-based assessment of the quality of the health care system for children and youth with special health care needs using a framework of six health care system quality indicators. 49,242 interviews with parents of children with special health care needs from the 2009-10 National Survey of Children with Special Health Care Needs (NS-CSHCN) were examined to determine the extent to which CSHCN had access to six quality indicators of a well-functioning system of services. Criteria for determining access to each indicator were established and applied to the survey data to estimate the proportion of CSHCN meeting each quality indicator by socio-demographic status and functional limitations. 17.6% of CSHCN received care consistent with all six quality indicators. Results for each component of the system quality framework ranged from a high of 70.3% of parents reporting that they shared decision-making with healthcare providers to a low of 40% of parents reporting receipt of services needed for transition to adult health care. Attainment rates were lower for CSHCN of minority racial and ethnic groups, those residing in households where English was not the primary language, those in lower income households, and those most impacted by their health condition. Only a small proportion of CSHCN receive all identified attributes of a high-quality system of services. Moreover, significant disparities exist whereby those most impacted by their conditions and those in traditionally disadvantaged groups are served least well by the current system. A small proportion of CSHCN appear to remain essentially outside of the system, having met few if any of the elements studied.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Percent distribution of the number of age appropriate quality indicators met by CSHCN aged 0–17 years
See this image and copyright information in PMC

References

    1. McPherson M, Arango P, Fox H, Lauver C, McManus M, Newacheck P, et al. A new definition of children with special health care needs. Pediatrics. 1998;102(1):137–140. - PubMed
    1. Perrin JM, Bloom SR, Gortmaker SL. The increase of childhood conditions in the United States. JAMA. 2007;297(24):2755–2759. - PubMed
    1. Bethell CD, Read D, Blumberg SJ, Newacheck PW. What is the prevalence of children with special health care needs? Maternal and Child Health Journal. 2008;12(1):1–14. - PubMed
    1. Mangione-Smith R, DeCristofara AH, Setodji CM, Keesey J, Klein DJ, Adams JL, et al. The quality of ambulatory care delivered to children in the United States. New England Journal of Medicine. 2007;357(15):1515–1523. - PubMed
    1. National Research Council Institute of Medicine. Children’s health, the nation’s wealth: Assessing and improving child health. Committee on evaluation of children’s health. Washington (DC): The National Academies Press; 2004.

MeSH terms