Care coordination for CSHCN: associations with family-provider relations and family/child outcomes.
OBJECTIVE
To examine the association between receiving adequate care coordination (CC) with family-provider relations and family/child outcomes.


METHODS
We analyzed data from the 2005-2006 National Survey of Children With Special Health Care Needs. Eligible subjects were the 88% of families asked about experience with CC, service use, and communication. Respondents also reported on demographic characteristics, health status, family-provider relations, and family/child outcomes. Weighted, multivariate logistic regression models were constructed to assess independent associations of adequate CC with outcomes.


RESULTS
Among families with children with special health care needs asked about CC, 68.2% reported receiving some type of CC help. Of these, 59.2% reported receiving adequate CC help, and 40.8% reported inadequate CC. Families that reported adequate compared with inadequate CC had increased odds of receiving family-centered care, experiencing partnerships with professionals, and satisfaction with services. They had decreased odds of having problems with referrals for specialty care, missing >6 school days because of illness (previous year), and visiting the emergency department more than twice in the previous 12 months (P < .001). Those who reported adequate compared with inadequate CC had decreased odds of the following: more than $500/y of out-of-pocket expenses, family financial burden, spending more than 4 hours/week coordinating care, and stopping/reducing work hours.


CONCLUSIONS
Parental report of adequate CC was associated with favorable family-provider relations and family/child outcomes. Additional efforts are needed to discern which aspects of CC are most beneficial and for which subgroups of children with special health care needs.
Turchi
Renee M
RM
Department of Pediatrics, St Christopher's Hospital for Children, Drexel University School of Public Heath, 15th and Race Streets, Mail Stop 1032, Philadelphia, PA 19102, USA. renee.turchi@drexelmed.edu
Berhane
Zekarias
Z
Bethell
Christina
C
Pomponio
Amber
A
Antonelli
Richard
R
Minkovitz
Cynthia S
CS
D000041:Absenteeism; D000293:Adolescent; D000553:Ambulatory Care / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D019988:Children with Disabilities / Q000706:statistics & numerical data*; D004522:Educational Status; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D004651:Employment / Q000706:statistics & numerical data; D022143:Family Nursing / Q000706:statistics & numerical data; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007223:Infant; D007231:Infant, Newborn; D007348:Insurance, Health / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009934:Organization and Administration; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D014481:United States