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Swann-Thomsen HE, Lindsay R, Rourk S, Hofacer R, Nguyen E. National Survey Data to Evaluate Case Management Services: A Systematic Review on Care Coordination Using the National Survey of Children With Special Health Care Needs. Prof Case Manag 2022; 27:124-140. [PMID: 35363658 DOI: 10.1097/ncm.0000000000000551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Hillary E Swann-Thomsen
- Hillary E. Swann-Thomsen, PhD, was a postdoctoral fellow in the Idaho Center for Health Research at Idaho State University during the time of this work. She is currently an applied research scientist at St. Luke's Health System. Her research focuses on improving quality of care in vulnerable patient populations
- Ryan Lindsay, PhD, MPH, is an associate professor in the Department of Community and Public Health at Idaho State University with interests in the household production of health, healthcare access, and the interaction between substance use and infectious diseases. His research highlights the health of addicted, deaf, homeless, immigrant, and sex worker populations
- Seth Rourk, PharmD, was a student pharmacist at Idaho State University College of Pharmacy during the time of this work. He is currently an instructor and affiliate faculty in the Department of Pharmacy Practice at Idaho State University
- Rylon Hofacer, PhD, was a postdoctoral fellow in the Idaho Center for Health Research at Idaho State University during the time of this work. He is currently a healthcare economics analyst at Blue Cross of Idaho
- Elaine Nguyen, PharmD, MPH, is an assistant professor in the Department of Pharmacy Practice at Idaho State University. She is interested in chronic disease management, health services-related research, and the use of technology in patient care
| | - Ryan Lindsay
- Hillary E. Swann-Thomsen, PhD, was a postdoctoral fellow in the Idaho Center for Health Research at Idaho State University during the time of this work. She is currently an applied research scientist at St. Luke's Health System. Her research focuses on improving quality of care in vulnerable patient populations
- Ryan Lindsay, PhD, MPH, is an associate professor in the Department of Community and Public Health at Idaho State University with interests in the household production of health, healthcare access, and the interaction between substance use and infectious diseases. His research highlights the health of addicted, deaf, homeless, immigrant, and sex worker populations
- Seth Rourk, PharmD, was a student pharmacist at Idaho State University College of Pharmacy during the time of this work. He is currently an instructor and affiliate faculty in the Department of Pharmacy Practice at Idaho State University
- Rylon Hofacer, PhD, was a postdoctoral fellow in the Idaho Center for Health Research at Idaho State University during the time of this work. He is currently a healthcare economics analyst at Blue Cross of Idaho
- Elaine Nguyen, PharmD, MPH, is an assistant professor in the Department of Pharmacy Practice at Idaho State University. She is interested in chronic disease management, health services-related research, and the use of technology in patient care
| | - Seth Rourk
- Hillary E. Swann-Thomsen, PhD, was a postdoctoral fellow in the Idaho Center for Health Research at Idaho State University during the time of this work. She is currently an applied research scientist at St. Luke's Health System. Her research focuses on improving quality of care in vulnerable patient populations
- Ryan Lindsay, PhD, MPH, is an associate professor in the Department of Community and Public Health at Idaho State University with interests in the household production of health, healthcare access, and the interaction between substance use and infectious diseases. His research highlights the health of addicted, deaf, homeless, immigrant, and sex worker populations
- Seth Rourk, PharmD, was a student pharmacist at Idaho State University College of Pharmacy during the time of this work. He is currently an instructor and affiliate faculty in the Department of Pharmacy Practice at Idaho State University
- Rylon Hofacer, PhD, was a postdoctoral fellow in the Idaho Center for Health Research at Idaho State University during the time of this work. He is currently a healthcare economics analyst at Blue Cross of Idaho
- Elaine Nguyen, PharmD, MPH, is an assistant professor in the Department of Pharmacy Practice at Idaho State University. She is interested in chronic disease management, health services-related research, and the use of technology in patient care
| | - Rylon Hofacer
- Hillary E. Swann-Thomsen, PhD, was a postdoctoral fellow in the Idaho Center for Health Research at Idaho State University during the time of this work. She is currently an applied research scientist at St. Luke's Health System. Her research focuses on improving quality of care in vulnerable patient populations
- Ryan Lindsay, PhD, MPH, is an associate professor in the Department of Community and Public Health at Idaho State University with interests in the household production of health, healthcare access, and the interaction between substance use and infectious diseases. His research highlights the health of addicted, deaf, homeless, immigrant, and sex worker populations
- Seth Rourk, PharmD, was a student pharmacist at Idaho State University College of Pharmacy during the time of this work. He is currently an instructor and affiliate faculty in the Department of Pharmacy Practice at Idaho State University
- Rylon Hofacer, PhD, was a postdoctoral fellow in the Idaho Center for Health Research at Idaho State University during the time of this work. He is currently a healthcare economics analyst at Blue Cross of Idaho
- Elaine Nguyen, PharmD, MPH, is an assistant professor in the Department of Pharmacy Practice at Idaho State University. She is interested in chronic disease management, health services-related research, and the use of technology in patient care
| | - Elaine Nguyen
- Hillary E. Swann-Thomsen, PhD, was a postdoctoral fellow in the Idaho Center for Health Research at Idaho State University during the time of this work. She is currently an applied research scientist at St. Luke's Health System. Her research focuses on improving quality of care in vulnerable patient populations
- Ryan Lindsay, PhD, MPH, is an associate professor in the Department of Community and Public Health at Idaho State University with interests in the household production of health, healthcare access, and the interaction between substance use and infectious diseases. His research highlights the health of addicted, deaf, homeless, immigrant, and sex worker populations
- Seth Rourk, PharmD, was a student pharmacist at Idaho State University College of Pharmacy during the time of this work. He is currently an instructor and affiliate faculty in the Department of Pharmacy Practice at Idaho State University
- Rylon Hofacer, PhD, was a postdoctoral fellow in the Idaho Center for Health Research at Idaho State University during the time of this work. He is currently a healthcare economics analyst at Blue Cross of Idaho
- Elaine Nguyen, PharmD, MPH, is an assistant professor in the Department of Pharmacy Practice at Idaho State University. She is interested in chronic disease management, health services-related research, and the use of technology in patient care
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Wells R, Daniel P, Barger B, Rice CE, Bandlamudi M, Crimmins D. Impact of medical home-consistent care and child condition on select health, community, and family level outcomes among children with special health care needs. CHILDRENS HEALTH CARE 2020. [DOI: 10.1080/02739615.2020.1852085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Rebecca Wells
- Center for Leadership in Disability, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Patricia Daniel
- Center for Leadership in Disability, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Brian Barger
- Center for Leadership in Disability, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Catherine E. Rice
- Emory Autism Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Maitreyi Bandlamudi
- Center for Leadership in Disability, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Daniel Crimmins
- Center for Leadership in Disability, School of Public Health, Georgia State University, Atlanta, GA, USA
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Miller LS, Wu M, Schettine AM, Cogan LW. Identifying Children with Special Health Care Needs Using Medicaid Data in New York State Medicaid Managed Care. Health Serv Res 2018; 53:4157-4177. [PMID: 30238977 DOI: 10.1111/1475-6773.13047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The ability to identify children with special health care needs (CSHCN) is crucial to evaluate disparities in the quality of health care for children in Medicaid Managed Care. We developed and assessed the accuracy of a new method to classify CSHCN. DATA SOURCES Secondary data analysis was conducted using NYS Medicaid administrative data and the Children with Chronic Conditions Screener (CCC Screener). STUDY DESIGN This study included 5,907 NYS Medicaid beneficiaries (17 years old or younger) whose parents completed the CCC Screener in 2014. Medicaid administrative data were used to create a risk score to assess the risk of special needs, and a cut point was identified to differentiate between children with versus without special needs. Diagnostic accuracy of the method was assessed using sensitivity and specificity analyses. PRINCIPAL FINDINGS Applying the CCC Screener as the "gold standard," the risk score correctly classified the majority of CSHCN as positive (sensitivity = 75 percent) and the majority of the children without special needs as negative (specificity = 79 percent). This method demonstrated decent diagnostic ability (AUC = 0.77). CONCLUSIONS Our method can identify CSHCN in the NYS Medicaid Managed Care population and will help the State monitor the quality of care for this vulnerable population.
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Affiliation(s)
- Lauren S Miller
- New York State Department of Health, Office of Quality and Patient Safety, Albany, NY
| | - Meng Wu
- New York State Department of Health, Office of Quality and Patient Safety, Albany, NY
| | - Anne M Schettine
- New York State Department of Health, Office of Quality and Patient Safety, Albany, NY
| | - Lindsay W Cogan
- New York State Department of Health, Office of Quality and Patient Safety, Albany, NY.,Department of Health Policy Management & Behavior, School of Public Health, University at Albany, Albany, NY
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Son E, Moring NS, Igdalsky L, Parish SL. Navigating the health-care system in community: Perspectives from Asian immigrant parents of children with special health-care needs. J Child Health Care 2018; 22:251-268. [PMID: 29374977 DOI: 10.1177/1367493517753084] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Children with special health-care needs (CSHCNs) face notable barriers to health-care access and to receiving quality and family-centered care, despite higher health-care utilization rates. Within the population of CSHCNs, there are significant inequities in health-care quality impacting immigrants who have migrated to the United States. However, little is known about the experiences and needs of Asian immigrant families who have CSHCNs. This study aimed to explore how Asian immigrant parents of CSHCNs view their child's health-care access, quality, and utilization. We conducted semi-structured qualitative interviews with 22 Vietnamese- and Cantonese-speaking parents of CSHCNs. Participants were recruited through community partners. Interviews were transcribed, translated, and coded using content analysis. Participants were generally satisfied with their children's care and had strong relationships with their primary care doctors who were often culturally 'matched'. However, participants experienced several important and culturally specific barriers, including gaps in their understanding of the health-care system, language barriers, and a sense of alienation. Parents frequently turned to informal and community supports for assistance in navigating the US health-care system. Further research to understand the drivers of health disparities and policy level solutions is warranted.
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Affiliation(s)
- Esther Son
- 1 Department of Social Work, School of Health Sciences, College of Staten Island, The City University of New York, New York, USA
| | - Nechama Sammet Moring
- 2 Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
| | - Leah Igdalsky
- 2 Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
| | - Susan L Parish
- 3 Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts, USA
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Schokkaert E, Steel J, Van de Voorde C. Out-of-Pocket Payments and Subjective Unmet Need of Healthcare. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2017; 15:545-555. [PMID: 28432643 DOI: 10.1007/s40258-017-0331-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We present a critical review of the literature that discusses the link between the level of out-of-pocket payments in developed countries and the share of people in these countries reporting that they postpone or forgo healthcare for financial reasons. We discuss the pros and cons of measuring access problems with this subjective variable. Whereas the quantitative findings in terms of numbers of people postponing care must be interpreted with utmost caution, the picture for the vulnerable groups in society is reasonably robust and unsurprising: people with low incomes and high morbidity and incomplete (or non-existent) insurance coverage are most likely to postpone or forgo healthcare for financial reasons. It is more surprising that people with high incomes and generous insurance coverage also report that they postpone care. We focus on some policy-relevant issues that call for further research: the subtle interactions between financial and non-financial factors, the possibility of differentiation of out-of-pocket payments between patients and between healthcare services, and the normative debate around accessibility and affordability.
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Affiliation(s)
- Erik Schokkaert
- Department of Economics, KU Leuven and CORE, Université catholique de Louvain, Louvain-la-Neuve, Belgium.
| | - Jonas Steel
- Department of Economics, KU Leuven, Louvain, Belgium
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Care coordination, the family-centered medical home, and functional disability among children with special health care needs. Acad Pediatr 2015; 15:185-90. [PMID: 25311760 DOI: 10.1016/j.acap.2014.08.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 08/18/2014] [Accepted: 08/25/2014] [Indexed: 11/22/2022]
Abstract
BACKGROUND Children with special health care needs (CSHCN) are at increased risk for functional disabilities. Care coordination has been shown to decrease unmet health service use but has yet been shown to improve functional status. We hypothesize that care coordination services lower the odds of functional disability for CSHCN and that this effect is greater within the context of a family-centered medical home. A secondary objective was to test the mediating effect of unmet care needs on functional disability. METHODS Our sample included children ages 0 to 17 years participating the 2009-2010 National Survey of Children with Special Health Care Needs. Care coordination, unmet needs, and disability were measured by parent report. We used logistic regression models with covariate adjustment for confounding and a mediation analysis approach for binary outcomes to assess the effect of unmet needs. RESULTS There were 34,459 children in our sample. Care coordination was associated with lower odds of having a functional disability (adjusted odds ratio 0.82, 95% confidence interval 0.77, 0.88). This effect was greater for care coordination in the context of a medical home (adjusted odds ratio 0.71, 95% confidence interval 0.66, 0.76). The relationship between care coordination and functional disability was mediated by reducing unmet services. CONCLUSIONS Care coordination is associated with lower odds of functional disability among CSHCN, especially when delivered in the setting of a family-centered medical home. Reducing unmet service needs mediates this effect. Our findings support a central role for coordination services in improving outcomes for vulnerable children.
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Minh A, Patel S, Bruce-Barrett C, OʼCampo P. Letting youths choose for themselves: concept mapping as a participatory approach for program and service planning. FAMILY & COMMUNITY HEALTH 2015; 38:33-43. [PMID: 25423242 DOI: 10.1097/fch.0000000000000060] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Ensuring that the voices of youths are heard is key in creating services that align with the needs and goals of youths. Concept mapping, a participatory mixed-methods approach, was used to engage youths, families, and service providers in an assessment of service gaps facing youth in an underserviced neighborhood in Toronto, Canada. We describe 6 phases of concept mapping: preparation, brainstorming, sorting and rating, analysis, interpretation, and utilization. Results demonstrate that youths and service providers vary in their conceptualizations of youth service needs and priorities. Implications for service planning and for youth engagement in research are discussed.
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Affiliation(s)
- Anita Minh
- School of Population and Public Health, The University of British Columbia Vancouver, British Columbia, Canada (Ms Minh); Centre for Research on Inner City Health, The Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada (Ms Minh and Drs Patel and O'Campo); School of Early Childhood Studies, Faculty of Community Services, Ryerson University, Toronto, Ontario, Canada (Dr Patel); Hospital for Sick Children, Toronto, Ontario, Canada (Ms Bruce-Barrett); and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (Dr O'Campo)
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Miller JE, Nugent CN, Gaboda D, Russell LB. Reasons for unmet need for child and family health services among children with special health care needs with and without medical homes. PLoS One 2013; 8:e82570. [PMID: 24340042 PMCID: PMC3858312 DOI: 10.1371/journal.pone.0082570] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 10/24/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Medical homes, an important component of U.S. health reform, were first developed to help families of children with special health care needs (CSHCN) find and coordinate services, and reduce their children's unmet need for health services. We hypothesize that CSHCN lacking medical homes are more likely than those with medical homes to report health system delivery or coverage problems as the specific reasons for unmet need. METHODS Data are from the 2005-2006 National Survey of Children with Special Health Care Needs (NS-CSHCN), a national, population-based survey of 40,723 CSHCN. We studied whether lacking a medical home was associated with 9 specific reasons for unmet need for 11 types of medical services, controlling for health insurance, child's health, and sociodemographic characteristics. RESULTS Weighted to the national population, 17% of CSHCN reported at least one unmet health service need in the previous year. CSHCN without medical homes were 2 to 3 times as likely to report unmet need for child or family health services, and more likely to report no referral (OR= 3.3), dissatisfaction with provider (OR=2.5), service not available in area (OR= 2.1), can't find provider who accepts insurance (OR=1.8), and health plan problems (OR=1.4) as reasons for unmet need (all p<0.05). CONCLUSIONS CSHCN without medical homes were more likely than those with medical homes to report health system delivery or coverage reasons for unmet child health service needs. Attributable risk estimates suggest that if the 50% of CSHCN who lacked medical homes had one, overall unmet need for child health services could be reduced by as much as 35% and unmet need for family health services by 40%.
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Affiliation(s)
- Jane E. Miller
- Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, New Jersey, United States of America
- Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, New Jersey, United States of America
| | - Colleen N. Nugent
- Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, New Jersey, United States of America
| | - Dorothy Gaboda
- Center for State Health Policy, Rutgers University, New Brunswick, New Jersey, United States of America
| | - Louise B. Russell
- Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, New Jersey, United States of America
- Department of Economics, Rutgers University, New Brunswick, New Jersey, United States of America
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McManus BM, Robert S, Albanese A, Sadek-Badawi M, Palta M. Predictors of receiving therapy among very low birth weight 2-year olds eligible for Part C early intervention in Wisconsin. BMC Pediatr 2013; 13:106. [PMID: 23845161 PMCID: PMC3718652 DOI: 10.1186/1471-2431-13-106] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 07/02/2013] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The Individuals with Disabilities Education Act (Part C) authorizes states to establish systems to provide early intervention services (e.g., therapy) for children at risk, with the incentive of federal financial support. This study examines family and neighborhood characteristics associated with currently utilizing physical, occupational, or speech therapy among very low birthweight (VLBW) 2-year-old children who meet Wisconsin eligibility requirements for early intervention services (EI) due to developmental delay. METHODS This cross-sectional analysis used data from the Newborn Lung Project, a regional cohort study of VLBW infants hospitalized in Wisconsin's newborn intensive care units during 2003-2004. We included the 176 children who were age two at follow-up, and met Wisconsin state eligibility requirements for EI based on developmental delay. Exact logistic regression was used to describe child and neighborhood socio-demographic correlates of parent-reported receipt of therapy. RESULTS Among VLBW children with developmental delay, currently utilizing therapy was higher among children with Medicaid (aOR = 5.3, 95% CI: 1.3, 28.3) and concomitant developmental disability (aOR = 5.2, 95% CI: 2.1, 13.3) and lower for those living in a socially more disadvantaged neighborhood (aOR=0.48, 95% CI: 0.21, 0.98, per tertile). CONCLUSIONS Among a sample of VLBW 2-year olds with developmental delays who are EI-eligible in WI, 4 out of 5 were currently receiving therapy, per parent report. Participation in Medicaid positively influences therapy utilization. Children with developmental difficulties who live in socially disadvantaged neighborhoods are at highest risk for not receiving therapy.
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Affiliation(s)
- Beth Marie McManus
- Department of Health Systems, Management & Policy, Colorado School of Public Health, 13001 E. 17th Place, MS B117, Aurora, CO 80045, USA
| | - Stephanie Robert
- Department of Social Work, University of Wisconsin-Madison, Madison, WI, USA
| | - Aggie Albanese
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Mona Sadek-Badawi
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Mari Palta
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
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Miller K. Care Coordination Impacts on Access to Care for Children with Special Health Care Needs Enrolled in Medicaid and CHIP. Matern Child Health J 2013; 18:864-72. [DOI: 10.1007/s10995-013-1312-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Agrawal R, Shah P, Zebracki K, Sanabria K, Kohrman C, Kohrman AF. The capacity of primary care pediatricians to care for children with special health care needs. Clin Pediatr (Phila) 2013; 52:310-4. [PMID: 23426230 DOI: 10.1177/0009922813476572] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To measure the willingness and ability of primary care pediatricians (PCPs) to accept children and youth with special health care needs (CYSHCN) into their practices. METHODS Surveys were mailed to 1441 members of the Illinois Chapter of the American Academy of Pediatrics practicing primary care. RESULTS In all, 376 physicians were eligible for analyses. When asked if they would accept additional CYSHCN, 6% selected "yes," 34% selected "yes, with supports," and 60% selected "no." PCPs closer to residency or with intermediate numbers of CYSHCN in their practices were more willing to add additional CYSHCN. PCPs preparedness to care for various conditions ranged from 96% for asthma to 53% for spina bifida. Familiarity with programs ranged from 89% for Early Intervention to 4% to 22% for the state's waiver programs. CONCLUSIONS Most PCPs did not want additional CYSHCN in their practices. Variation exists in PCP preparation to care for varying conditions and in familiarity with supportive programs.
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Affiliation(s)
- Rishi Agrawal
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Jacquez F, Vaughn LM, Wagner E. Youth as partners, participants or passive recipients: a review of children and adolescents in community-based participatory research (CBPR). AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2013; 51:176-89. [PMID: 22718087 DOI: 10.1007/s10464-012-9533-7] [Citation(s) in RCA: 192] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Community-based participatory research (CBPR) is an orientation to research that places value on equitable collaborations between community members and academic partners, reflecting shared decision making throughout the research process. Although CBPR has become increasingly popular for research with adults, youth are less likely to be included as partners. In our review of the literature, we identified 399 articles described by author or MeSH keyword as CBPR related to youth. We analyzed each study to determine youth engagement. Not including misclassified articles, 27 % of percent of studies were community-placed but lacked a community partnership and/or participatory component. Only 56 (15 %) partnered with youth in some phase of the research process. Although youth were most commonly involved in identifying research questions/priorities and in designing/conducting research, most youth-partnered projects included children or adolescents in several phases of the research process. We outline content, methodology, phases of youth partnership, and age of participating youth in each CBPR with youth project, provide exemplars of CBPR with youth, and discuss the state of the youth-partnered research literature.
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Affiliation(s)
- Farrah Jacquez
- Department of Psychology, University of Cincinnati, 4150H Edwards Building One, PO Box 2120376, Cincinnati, OH 45221-0376, USA.
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Agrawal R, Shah P, Zebracki K, Sanabria K, Kohrman C, Kohrman AF. Barriers to care for children and youth with special health care needs: perceptions of Illinois pediatricians. Clin Pediatr (Phila) 2012; 51:39-45. [PMID: 21856963 DOI: 10.1177/0009922811417288] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE. To assess primary care pediatricians' (PCPs') perceptions of caring for children and youth with special health care needs (CYSHCN). METHODS. Cross-sectional survey of Illinois pediatricians. RESULTS. Thirty-five percent of surveys were returned and 26% were analyzed. The top 3 perceived barriers were insufficient time (72%), insufficient reimbursement (68%), and lack of support services (59%). Insufficient interest was the least cited barrier (19%). Preparedness to perform tasks related to care of CYSHCN ranged from 89% for accessing early intervention services to 24% for billing and coding. The percentage of PCPs somewhat or very comfortable providing primary care to patients with technology dependence ranged from 75% for blood glucose monitoring to 12% for dialysis. CONCLUSIONS. The issues of time, reimbursement, billing, and coding are perceived as significant barriers to the care CYSHCN. There is substantial variation in PCPs' comfort in the care of CYSHCN who require the assistance of medical technologies.
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Affiliation(s)
- Rishi Agrawal
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Richmond N, Tran T, Berry S. Receipt of transition services within a medical home: do racial and geographic disparities exist? Matern Child Health J 2011; 15:742-52. [PMID: 20602158 DOI: 10.1007/s10995-010-0635-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES (1) Rank states and southern region by racial disparity between black and white Youth with Special Health Care Needs (YSHCN) for Healthcare Transition receipt; (2) Determine if a racial and geographic disparity exists after control of characteristics. METHODS The 05/06 National Survey of Children with Special Health Care Needs data were used. A composite of Medical Home and Transition Outcome Measures captured Healthcare Transition. If both were met, Healthcare Transition was received; otherwise, if neither were met, it was not received. Race was grouped as Non-Hispanic black or white. Census Bureau regions defined geography. South was categorized as Deep South or remaining southern states. Characteristics included sex, age, health condition effect, education, poverty, adequate insurance, and metropolitan status. Observations were limited to YSHCN. Chi-square and logistic regression were conducted. Alpha was set to .05. RESULTS A national 42% healthcare transition rate, and 25% racial gap was calculated (higher rate among white YSHCN). White YSHCN had more than twice, and Midwestern had 44% higher Healthcare Transition odds in regression analysis; sex, health condition effect, insurance, and education remained significant. For the Southern region, the Healthcare Transition rate was 38% with a 26% racial gap. White YSHCN had about 2.6 higher odds, and southern geography was not associated in regression analysis. Education, poverty, adequate insurance, and health condition effect remained significant. CONCLUSIONS A low Healthcare Transition rate was found, and disparities are poignant. Culturally salient intervention programs to address racial and geographic disparities are needed for Healthcare Transition eligible YSHCN.
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Affiliation(s)
- Nicole Richmond
- Louisiana State University Health Sciences Center, School of Medicine, Department of Pediatrics/Louisiana Office of Public Health, Children's Special Health Services Program, 1010 Common Street Suite 610, New Orleans, LA 70112, USA.
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Chen HY, Cisler RA. Assessing Health-Related Quality of Life Among Children With Special Health Care Needs in the United States. CHILDRENS HEALTH CARE 2011. [DOI: 10.1080/02739615.2011.617239] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Yucel RM, He Y, Zaslavsky AM. Gaussian-based routines to impute categorical variables in health surveys. Stat Med 2011; 30:3447-60. [PMID: 21976366 DOI: 10.1002/sim.4355] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Revised: 06/22/2011] [Accepted: 06/30/2011] [Indexed: 11/08/2022]
Abstract
The multivariate normal (MVN) distribution is arguably the most popular parametric model used in imputation and is available in most software packages (e.g., SAS PROC MI, R package norm). When it is applied to categorical variables as an approximation, practitioners often either apply simple rounding techniques for ordinal variables or create a distinct 'missing' category and/or disregard the nominal variable from the imputation phase. All of these practices can potentially lead to biased and/or uninterpretable inferences. In this work, we develop a new rounding methodology calibrated to preserve observed distributions to multiply impute missing categorical covariates. The major attractiveness of this method is its flexibility to use any 'working' imputation software, particularly those based on MVN, allowing practitioners to obtain usable imputations with small biases. A simulation study demonstrates the clear advantage of the proposed method in rounding ordinal variables and, in some scenarios, its plausibility in imputing nominal variables. We illustrate our methods on a widely used National Survey of Children with Special Health Care Needs where incomplete values on race posed a valid threat on inferences pertaining to disparities.
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Affiliation(s)
- Recai M Yucel
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, SUNY, One University Place, Rensselaer, NY 12144-3456, USA.
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McManus BM, Carle A, Acevedo-Garcia D, Ganz M, Hauser-Cram P, McCormick M. Modeling the social determinants of caregiver burden among families of children with developmental disabilities. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2011; 116:246-60. [PMID: 21591847 DOI: 10.1352/1944-7558-116.3.246] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
This study described predictors of caregiver burden among parents of children with developmental disabilities. The sample, obtained from the 2005-2006 National Survey of Children With Special Health Care Needs, included 12,225 children, aged 5 to 17 years, with a developmental disability. Structural equation modeling assessed the relationships between the factors of Caregiver Burden, Ease of Accessing and Navigating the Health Care System, and Unmet Health Care Needs. Caregiver burden was inversely associated with ease of accessing and navigating the health care system (β = -0.094, SE (β) = 0.045) and positively associated with unmet health care needs (β = 0.428, SE (β) = 0.036). Parents of poor, minority, and uninsured children experienced significantly greater caregiver burden. Bolstering services, particularly for vulnerable families, may ameliorate caregiver burden.
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Affiliation(s)
- Beth M McManus
- Harvard University School of Public Health, Boston, MA, USA.
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