Dougherty D, Chevarley F, Bethell C; AcademyHealth. Meeting (2003 : Nashville, Tenn.).

Abstr AcademyHealth Meet. 2003; 20: abstract no. 306.

Agency for Healthcare Research and Quality, Office of Priority Populations Research, 2101 E. Jefferson St. Suite 602, Rockville, MD 20852 Tel. (301) 594-2051 Fax (301) 594-7194

RESEARCH OBJECTIVE: To understand patient centeredness and timeliness, two important domains of quality, as well as an aspect of coordination of care, comparing all children with children with special health care needs. STUDY DESIGN: In 2000, AHRQ's Medical Expenditure Panel Survey Household Component administered a questionnaire to parents that included the validated Chldren with Special Health Care Needs analytic tool, and selected high priority CAHPS items on parents'and childrens' experiences of care. POPULATION STUDIED: The MEPS nationally representative sample of parents. PRINCIPAL FINDINGS: Results were identified for timeliness, patient-centeredness, and coordination of care. Timeliness: a smaller percentage of CSHCN than children without SHCN were always able to get routine appointments as soon as wanted (43.2% v. 54.4%); the differences between CSCHN and not were greater for adolescents (37.9% v. 53.9%); Patient-centeredness: 1) Parents of CHSCN were less likely to report that providers always listened carefully; the gap between adolescents with and without SHCN (53.6% v. 66.4%) was greater than for younger children; 2) Differences in ratings of how often the child's health providers spent enough time were significant only for adolescents (46.5% of adolescents with SHCN v. 57.9% of adolescents without SHCN). Coordination of care: Parents of CSHCN were not more likely to report that they had a problem getting a referral to a needed specialist for their child than parents children without SHCN. All reported differences are p <.05 or less. CONCLUSIONS: Despite their arguably higher needs for timely and patient-centered care, CSHCN experience care that is of poorer quality along these domains than other children. Adolescents with special health care needs were found to have worse care on these domains, even as reported by their parents. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: More attention is needed to improving patient-centeredness and timeliness of care for children with special health care needs, in particular for those who are adolescents.

Publication Types:

• Meeting Abstracts

Keywords:

• Adolescent
• Child
• Child Health Services
• Data Collection
• Health Expenditures
• Health Services Needs and Demand
• Humans
• Needs Assessment
• Parents
• Patient-Centered Care
• Poverty
• Questionnaires
• economics
• hsrmtgs

Other ID:

• GWHSR0003607

UI: 102275286

From Meeting Abstracts