Survey Results

Variable Name: MCHB Core Outcome #2: CSHCN who receive coordinated, ongoing, comprehensive care within a medical home

Survey Items: A total of 19 different survey questions are used to develop the overall composite score for having a Medical Home (see Additional Notes section for more information)

Denominator: CSHCN age 0 -17 years

Numerator: CSHCN receiving adequate care on all needed components of medical home assessed by the survey; CSHCN who did not achieve this outcome

Revisions and Changes: One minor revision was undertaken between the 2005/06 and 2009/10 NS-CSHCN surveys. An item assessing whether or not the child or child's family required an interpreter and whether or not the interpreter was usually or always provided was dropped from the survey due to low prevalence.

Additional Notes: The American Academy of Pediatrics' (AAP) description of a "medical home" lists seven defining components: accessible, continuous, comprehensive, family-centered, coordinated, compassionate and culturally effective. Ideally, these seven components are delivered by doctor or other health professional who knows the child well. Five of the 7 components of medical home and the presence of a personal doctor or nurse are assessed by the National Survey of CSHCN. The overall medical home measure is a composite score derived from five different subparts based on 19 different survey items. To qualify as having a medical home, a child must have a personal doctor or nurse and meet the criteria for adequate care on every needed component. For additional details on medical home, including SAS and SPSS scoring programs, please visit www.childhealthdata.org/browse/medicalhome. If you have further questions, please email: cahmi@ohsu.edu

Treatment of Unknown Values: Unknown values (responses coded as 'refused', 'don't know', or system missing) are not included in the denominator when calculating prevalence estimates and weighted population counts displayed in the data query results table. In nearly every case, the proportion of unknown values is less than 1% and the exclusion of these values does not change the prevalence estimates (%) and only marginally affects the weighted population counts (Weighted Est.). Exceptions are noted in the form of a Data Alert at the bottom of a results table.

History and Development: The Maternal and Child Health Bureau leads the development of the NS-CSHCN survey, indicators and performance measures, in collaboration with the National Center for Health Statistics (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. Previously validated questions and scales are used when available. 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 DRC/CAHMI staff prior to public release.