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  • Measure Summary
  • NQMC:009234
  • Apr 2013

Care coordination: percentage of children who needed care coordination help but did not receive all that they needed.

2011/12 National Survey of Children's Health. CATI instrument (full-length survey). Rockville (MD): Health Resources and Service Administration, Maternal and Child Health Bureau, and Centers for Disease Control and Prevention, National Center for Health Statistics; 2012. 126 p.

View the original measure documentation External Web Site Policy

This is the current release of the measure.

This measure updates a previous version: National Survey of Children's Health. CATI instrument (full-length survey). Rockville (MD): Health Resources and Service Administration, Maternal and Child Health Bureau, and Centers for Disease Control and Prevention, National Center for Health Statistics; 2007. 112 p.

The measure developer reaffirmed the currency of this measure in October 2015.

Primary Measure Domain

Population Health Quality Measures: Population Experience

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the percentage of children who needed care coordination help but did not receive all that they needed, based on parents' response to the following items on the 2011-12 National Survey of Children's Health (NSCH):

  • K4Q20: During the past 12 months/Since (his/her) birth, how many times did [child] see a doctor, nurse, or other health care provider for preventive medical care such as a physical exam or well-child checkup?
    • Response choices for the above question are "__ times," "Don't know," and "Refused."
  • K4Q21: During the past 12 months/Since (his/her) birth, how many times did [child] see a dentist for preventive dental care, such as check-ups and dental cleanings?
    • Response choices for the above question are "__ times," "Don't know," and "Refused."
  • K4Q22: Mental health professionals include psychiatrists, psychologists, psychiatric nurses, and clinical social workers. During the past 12 months, has [child] received any treatment or counseling from a mental health professional?
    • Response choices for the above question are "Yes," "No," "Don't know," and "Refused."
  • K4Q24: Specialists are doctors like surgeons, heart doctors, allergy doctors, skin doctors, and others who specialize in one area of health care. During the past 12 months/Since (his/her) birth, did [child] see a specialist [other than a mental health professional]?
    • Response choices for the above question are "Yes," "No," "Don't know," and "Refused."
  • K5Q20: Does anyone help you arrange or coordinate [child]'s care among the different doctors or services that (he/she) uses?
    • Response choices for the above question are "Yes," "No," "Don't know," and "Refused."
  • K5Q21: During the past 12 months/Since (his/her) birth, have you felt that you could have used extra help arranging or coordinating [child]'s care among the different health care providers or services?
    • Response choices for the above question are "Yes," "No," "Don't know," and "Refused." 
  • K5Q22: During the past 12 months/Since (his/her) birth, how often did you get as much help as you wanted with arranging or coordinating [child]'s care? Would you say never, sometimes, or usually?
    • Response choices for the above question are "Never," "Sometimes," "Usually," "Don't know," and "Refused."

Rationale

Care coordination of health services is a critical component in a child having a medical home, which has been recognized as an objective by the U.S. Department of Health and Human Services' Healthy People 2010. Additionally, medical home is one of the 18 national performance measures established for the state Title V programs it administers.

Care coordination is critical to children who require multiple health care services and is a vital component in improving the access to health care specialists as well as ensuring quality care to patients. This is essential for children with special health care needs, who require additional therapies or services, in which care coordination would emphasize communication amongst doctors and would lead to a decrease in delayed services.

Health care providers, public health professionals and population-based health analysts can all benefit from knowing whether or not children are receiving quality care. The measure of care coordination adds a benefit of comparing children across populations or demographic groups as to where quality care is not being delivered (e.g., those children who are not receiving adequate care coordination).

Evidence for Rationale

Child and Adolescent Health Measurement Initiative (CAHMI). National Quality Measures Clearinghouse (NQMC) measure submission form: care coordination: percentage of children who needed care coordination help but did not receive all that they needed. 2013 Apr.  15 p.

Primary Health Components

Care coordination of health services; children

Denominator Description

Children age 0-17 years living in the United States, for whom a 2011-12 National Survey of Children's Health (NSCH) was completed, and who

  • Needed care coordination of services in the past 12 months (either K5Q20=Yes OR K5Q20=No AND K5Q21=Yes)

    AND

  • Visited at least two types of the following services in the past 12 months: preventive healthcare visit, preventive dental care visit, medical healthcare specialist, and/or mental health professional (K4Q20, K4Q21, K4Q22, K4Q24)

Numerator Description

Children from the denominator who needed care coordination help but whose parents did NOT receive all that they needed as indicated by the following:

  • Parents reported that they did not receive care coordination (K5Q20=No)

    AND

  • Parents reported that they have felt that they could have used more help arranging or coordinating child's care (K5Q21=Yes) AND parents reported that they did not get as much help as they wanted with arranging or coordinating child's care (K5Q22=Never or Sometimes)

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A formal consensus procedure, involving experts in relevant clinical, methodological, public health and organizational sciences
  • Focus groups
  • One or more research studies published in a National Library of Medicine (NLM) indexed, peer-reviewed journal

Additional Information Supporting Need for the Measure

  • Nationally, among children 0-17 who needed care coordination, 33.9% did NOT receive the coordination they needed.
  • Children with special health care needs (CSHCN) are more likely NOT to receive the care coordination they need compared with children not living with current chronic conditions, 43.6% vs. 28.6%.
  • Latino (41.3%) and African American (37.6%) children are much more likely to NOT receive care coordination when needed than White children (29.4%).
  • Children with public insurance are much more likely NOT to receive care coordination when needed than children with private health insurance, 37.8% vs. 30.1%.
  • Children who do NOT receive care coordination when needed are much more likely to be in poor health compared with those who do receive care coordination, 9.4% vs. 3.1%.

Evidence for Additional Information Supporting Need for the Measure

The National Survey of Children's Health. [internet]. Baltimore (MD): Child and Adolescent Health Measurement Initiative (CAHMI); [accessed 2013 Dec 20]. [1 p].

Extent of Measure Testing

The National Center for Health Statistics (NCHS) conducted testing of the 2011-12 National Survey for Children's Health (NSCH) Computer-Assisted Telephone Interview (CATI) to make sure the entire survey instrument was functioning properly. A total of 95,677 surveys were completed nationally for children between the ages of 0 and 17 years. The questionnaire was then revised and finalized based on feedback from participants in these interviews.

The Maternal and Child Health Bureau leads the development of the NSCH and National Survey of Children with Special Health Care Needs (NS-CSHCN) survey and indicators, in collaboration with the NCHS and a national technical expert panel. The expert panel includes representatives from other federal agencies, state Title V leaders, family organizations, and child health researchers, and experts in all fields related to the surveys (adolescent health, family and neighborhoods, early childhood and development etc.). Previously validated questions and scales are used when available. Extensive literature reviewing and expert reviewing of items is conducted for all aspects of the survey. Respondents' cognitive understanding of the survey questions is assessed during the pretest phase and revisions made as required. All final data components are verified by NCHS and Data Resource Center/Child and Adolescent Health Measurement Initiative (DRC/CAHMI) staff prior to public release. Face validity is conducted in comparing results with prior years of the survey and/or results from other implementations of items. No specific reliability results are available for this measure.

Evidence for Extent of Measure Testing

Blumberg SJ, Foster EB, Frasier AM, Satorius J, Skalland BJ, Nysse-Carris KL, Morrison HM, Chowdhury SR, O'Connor KS. Design and operation of the National Survey of Children's Health, 2007. Vital Health Stat 1. 2012 Jun;(55):1-149. PubMed External Web Site Policy

Child and Adolescent Health Measurement Initiative (CAHMI). National Quality Measures Clearinghouse (NQMC) measure submission form: care coordination: percentage of children who needed care coordination help but did not receive all that they needed. 2013 Apr.  15 p.

Section 5: medical home. In: Summary of 2007 NSCH pretest results. Baltimore (MD): Child and Adolescent Health Measurement Initiative (CAHMI); p. 10-11.

State of Use

Current routine use

Current Use

Care coordination

External oversight/Maternal and Child Health Bureau

External oversight/Medicaid

External oversight/State government program

Monitoring and planning

Monitoring health state(s)

National health policymaking

National reporting

Quality of care research

State/Provincial health policymaking

Measurement Setting

National Public Health Programs

Patient-centered Medical Homes

Transition

Type of Care Coordination

Coordination between providers and patient/caregiver

Professionals Involved in Delivery of Health Services

Does not apply to this measure (e.g., measure is not provider specific)

Least Aggregated Level of Services Delivery Addressed

State/Provincial

Statement of Acceptable Minimum Sample Size

Unspecified

Target Population Age

Age less than or equal to 17 years

Target Population Gender

Either male or female

Public Health Aims for Quality

Population-centered

National Quality Strategy Aim

Healthy People/Healthy Communities

National Quality Strategy Priority

Effective Communication and Care Coordination
Health and Well-being of Communities
Person- and Family-centered Care
Prevention and Treatment of Leading Causes of Mortality

IOM Care Need

Getting Better

Living with Illness

Staying Healthy

IOM Domain

Effectiveness

Patient-centeredness

Case Finding Period

Unspecified

Denominator Sampling Frame

Geographically defined

Denominator (Index) Event or Characteristic

Encounter

Geographic Location

Patient/Individual (Consumer) Characteristic

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Children age 0-17 years living in the United States for whom a 2011-12 National Survey of Children's Health (NSCH) was completed, and who

  • Needed care coordination of services in the past 12 months (either K5Q20=Yes OR K5Q20=No AND K5Q21=Yes)

    AND

  • Visited at least two types of the following services in the past 12 months: preventive healthcare visit, preventive dental care visit, medical healthcare specialist, and/or mental health professional (K4Q20, K4Q21, K4Q22, K4Q24)

Exclusions
Unspecified

Exclusions/Exceptions

Does not apply to this measure

Numerator Inclusions/Exclusions

Inclusions
Children from the denominator who needed care coordination help but whose parents did NOT receive all that they needed as indicated by the following:

  • Parent reports that they did not receive care coordination (K5Q20=No)

    AND

  • Parent reports that they have felt that they could have used more help arranging or coordinating child's care (K5Q21=Yes) AND parent reports that they did not get as much help as they wanted with arranging or coordinating child's care (K5Q22=Never or Sometimes)

Exclusions
Unspecified

Numerator Search Strategy

Fixed time period or point in time

Data Source

Patient/Individual survey

Type of Health State

Does not apply to this measure

Instruments Used and/or Associated with the Measure

2011-12 National Survey of Children's Health (NSCH)

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Composite/Scale

Interpretation of Score

Desired value is a lower score

Allowance for Patient or Population Factors

Analysis by high-risk subgroup (stratification by vulnerable populations)

Analysis by subgroup (stratification by individual factors, geographic factors, etc.)

Description of Allowance for Patient or Population Factors

This measure, administered in its most recent form (in the 2011-12 National Survey of Children's Health [NSCH]), includes a number of child demographic variables that allow for stratification of the findings by possible vulnerability:

  • Age
  • Gender
  • Geographic location
  • Race/ethnicity
  • Health insurance - status, type, consistency, adequacy
  • Primary household language
  • Household income
  • Special Health Care Needs - status and type
  • Family structure
  • Emotional, behavioral or developmental issues
  • Presence of a medical home

Standard of Comparison

External comparison at a point in, or interval of, time

External comparison of time trends

Internal time comparison

Original Title

Children with care coordination when needed.

Measure Collection Name

2011/12 National Survey of Children's Health

Submitter

Child and Adolescent Health Measurement Initiative - Nonprofit Organization

Developer

Child and Adolescent Health Measurement Initiative - Nonprofit Organization

Maternal and Child Health Bureau of the Health Resources and Service Administration - Federal Government Agency [U.S.]

National Center for Health Statistics of the Centers for Disease Control and Prevention - Federal Government Agency [U.S.]

Funding Source(s)

Maternal and Child Health Bureau of the Health Resources and Service Administration

Composition of the Group that Developed the Measure

External (non-governmental) technical expert panel members (2006): Paul Newacheck, DrPH, MPP (Chairperson) (University of California, San Francisco); Maja Altarac, MD, PhD (University of Alabama at Birmingham); Christina Bethell, PhD, MBA, MPH (Oregon Health and Science University); Neal Halfon, MD (University of California, Los Angeles); William Hollinshead, MD (Rhode Island Department of Health); Charles Irwin, MD (University of California, San Francisco); Jeffrey Lobas, MD, MPA (Iowa Child Health Specialty Clinics); Kristin Anderson Moore, PhD (Child Trends); Lynn Olson, PhD (American Academy of Pediatrics); Edward Schor, MD (The Commonwealth Fund); Judith Shaw, EdD, MPH, RN (University of Vermont)

Financial Disclosures/Other Potential Conflicts of Interest

The Child and Adolescent Health Measurement Initiative is partially supported by Cooperative Agreement 1-U59MC27866 from the Maternal and Child Health Bureau (MCHB), Health Resources and Services Administration, U.S. Department of Health and Human Services. No conflicts of interest exist.

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2013 Apr

Measure Maintenance

Every 4 years

Date of Next Anticipated Revision

No changes anticipated.

Measure Status

This is the current release of the measure.

This measure updates a previous version: National Survey of Children's Health. CATI instrument (full-length survey). Rockville (MD): Health Resources and Service Administration, Maternal and Child Health Bureau, and Centers for Disease Control and Prevention, National Center for Health Statistics; 2007. 112 p.

The measure developer reaffirmed the currency of this measure in October 2015.

Source(s)

2011/12 National Survey of Children's Health. CATI instrument (full-length survey). Rockville (MD): Health Resources and Service Administration, Maternal and Child Health Bureau, and Centers for Disease Control and Prevention, National Center for Health Statistics; 2012. 126 p.

Measure Availability

Source available from the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics Web site External Web Site Policy.

For more information, contact CAHMI at 615 North Wolfe Street, Room E4640, Baltimore, MD 21205; Phone: 410-955-1848; Fax: 503-494-2473; E-mail: info@cahmi.org: Web site: www.cahmi.org External Web Site Policy.

Companion Documents

The following are available:

  • Blumberg SJ, Foster EB, Frasier AM, Satorius J, Skalland BJ, Nysse-Carris KL, Morrison HM, Chowdhury SR, O'Connor KS. Design and operation of the National Survey of Children's Health, 2007. Vital Health Stat 1. 2012 Jun;(55):1-149. This document is available from the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics Web site External Web Site Policy.
  • Centers for Disease Control and Prevention (CDC), National Center for Health Statistics. 2011-2012 National Survey of Children's Health state and local area integrated telephone survey: frequently asked questions. Atlanta (GA): Centers for Disease Control and Prevention; 2013 Apr. 8 p. This document is available from the CDC National Center for Health Statistics Web site External Web Site Policy.
  • Child and Adolescent Health Measurement Initiative (CAHMI). 2011-2012 National Survey of Children's Health. SPSS code for data users: child health indicators and subgroups, version 1.0. Baltimore (MD): Data Resource Center for Child and Adolescent Health; 2013 Apr. 201 p. This document is available from the Data Resource Center for Child and Adolescent Health Web site External Web Site Policy.

NQMC Status

This NQMC summary was completed by ECRI Institute on October 13, 2011. The information was verified by the measure developer on November 3, 2011.

This NQMC summary was updated by ECRI Institute on May 13, 2014. The information was verified by the measure developer on June 18, 2014.

The information was reaffirmed by the measure developer on October 27, 2015.

Copyright Statement

No copyright restrictions apply.

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