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Survey Items: Over 50 different survey questions are used to construct this measure.
Denominator: Children age 12-17 years
Numerator: Children received care in a well-functioning system; Children who do not receive care in a well-functioning system
Revisions and Changes: The systems of care measure has changed, due to changes in the transition to adult healthcare measure (see NPM 12), the medical home measure (see NPM 11), and the adequacy of insurance measure (see NPM 15). For more information on content changes, click here . Due to changes in the survey’s mode of data collection and sampling frame, as well as adjustments to item wording where necessary, MCHB alerts data users that it is not be possible to compare estimates from the redesigned survey to those from previous iterations of the NSCH or NS-CSHCN or to conduct related trend analyses. The redesigned NSCH will support trend analyses beginning with data from 2016.
Additional Notes: This measure is comprised of six age-relevant measures for children age 12-17 years. Those six measures for children age 12-17 years include: family feels like they are a partner in their child’s care, child has a medical home, child had a preventive medical and dental visit, child has adequate insurance, child has no unmet need and barriers access to services, and preparation for adult transition. If a child has at least one valid positive response to any of these measures and the remainder of the components were missing or legitimately skipped, this child was categorized as receiving care in a well-functioning system in the 2016 scoring of this measure. Respondents with "missing" to all items were set to missing.
Treatment of Unknown Values: Missing values due to non-response or a “don’t know” response are not included in the denominator when calculating prevalence estimates and weighted population counts displayed in the data query results table. In the majority of cases, the proportion of missing values is less than 2%. Exceptions are noted in the form of a Data Alert at the bottom of a results table. The exclusion of these values does not change the prevalence estimates (%) and only marginally affects the weighted population counts (Pop. Est.). If missing cases are handled in any other way, details can be found in the "Additional notes" section above.
History and Development: The Maternal and Child Health Bureau (MCHB) funds and directs the National Survey of Children’s Health (NSCH), and develops survey content in collaboration with the U.S. Census Bureau and a Technical Expert Panel. The Technical Expert Panel consists of experts in survey methodology and children’s health, federal and state stakeholders, clinicians and researchers. The U.S. Census Bureau conducts the survey, oversees the sampling, and produces a final data set of survey results. Respondents’ cognitive understanding of the survey questions was assessed during the pretest phase and revisions were made. Previously validated questions and scales are used when available. Prior to 2016, the NSCH and the National Survey of Children with Special Health Care Needs were each conducted three times as interviewer-assisted telephone surveys using random digit dial sampling. In 2016, the two surveys were combined into a single self-administered questionnaire. Due to decline in the number of households with landline telephones, the NSCH now utilizes an address-based sampling method to select participating households, thus all invitations are sent by mail. Participants may choose to complete the survey either online using a secure website or a mailed paper version of the survey. All final data components are verified by the Census Bureau, MCHB and DRC/CAHMI staff prior to public release. More information can be found in the “Review the Surveys” section of this website.
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C.I. = 95% Confidence Interval. Percentages and population estimates (Pop.Est.) are weighted to represent child population in US.
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Data Source: National Survey of Children’s Health, Health Resources and Services Administration, Maternal and Child Health Bureau. https://mchb.hrsa.gov/data/national-surveys
Citation: Child and Adolescent Health Measurement Initiative. 2016 National Survey of Children’s Health (NSCH) data query. Data Resource Center for Child and Adolescent Health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Retrieved [mm/dd/yy] from [www.childhealthdata.org].