Core Outcomes: Key Measures of Performance

Children are screened early and continuously for special health care needs.

In public health, screening often refers to a population-based intervention to detect a particular condition or disease. However, as used in the context of this goal, screening is much more comprehensive and includes ongoing monitoring and assessment of children and youth to promote health and well-being through family-centered care practices. Seen this way, screening has two major goals. First, it is critical to identify, as early as possible, children in the general population who have special health care needs so that they and their families can receive appropriate services to reduce long term consequences and complications. Some needs may be identified in infancy, or during the perinatal period, while others may emerge later in childhood and adolescence. Second, and equally important, children and youth with special health care needs require ongoing assessments to identify newly emerging issues including developmental/behavioral issues, oral health, and psychosocial issues, and to prevent secondary conditions that may interfere with development and well-being. Ongoing assessment should also focus on identifying the unique strengths of each child and family.

Only the second component of screening—ongoing assessments for CSHCN—was measured in the NS-CSHCN. An estimate for this outcome was arrived at using two survey questions: whether or not CSHCN received routine preventive medical care in the past year and whether they received routine preventive dental care during the past year. Overall, this outcome was successfully achieved for 63.8 percent of CSHCN. Children’s likelihood of achieving this outcome did not vary substantially based on the impact of the condition on the child’s functional ability. However, children with higher family incomes were significantly more likely to be screened regularly: 77 percent of children with family incomes of 400 percent of the poverty level achieved this outcome, compared to 48 percent of children with family incomes below the poverty level.

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