title: Associations of family-centered care with health care outcomes for children with special health care needs.
abstract: The objective of this study is to examine the association of family-centered care (FCC) with specific health care service outcomes for children with special health care needs (CSHCN). The study is a secondary analysis of the 2005-2006 National Survey of Children with Special Health Care Needs. Receipt of FCC was determined by five questions regarding how well health care providers addressed family concerns in the prior 12 months. We measured family burden by reports of delayed health care, unmet need, financial costs, and time devoted to care; health status, by stability of health care needs; and emergency department and outpatient service use. All statistical analyses used propensity score-based matching models to address selection bias. FCC was reported by 65.6% of respondents (N = 38,915). FCC was associated with less delayed health care (AOR: 0.56; 95% CI: 0.48, 0.66), fewer unmet service needs (AOR: 0.53; 95% CI: 0.47, 0.60), reduced odds of ≥1 h/week coordinating care (AOR: 0.83; 95% CI: 0.74, 0.93) and reductions in out of pocket costs (AOR: 0.88; 95% CI: 0.80, 0.96). FCC was associated with more stable health care needs (AOR: 1.11; 95% CI: 1.01, 1.21), reduced odds of emergency room visits (AOR: 0.90; 95% CI: 0.82, 0.99) and increased odds of doctor visits (AOR: 1.25; 95% CI: 1.14, 1.37). Our study demonstrates associations of positive health and family outcomes with FCC. Realizing the health care delivery benefits of FCC may require additional encounters to build key elements of trust and partnership.
authors.affiliation: Center for Applied Research and Evaluation, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA. dzkuo@uams.edu
authors.forename: Dennis Z
authors.initials: DZ
authors.lastname: Kuo
authors.forename: T Mac
authors.initials: TM
authors.lastname: Bird
authors.forename: J Mick
authors.initials: JM
authors.lastname: Tilford
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services / Q000592:standards* / Q000706:statistics & numerical data*; D002675:Child, Preschool; D019988:Children with Disabilities / Q000706:statistics & numerical data*; D022143:Family Nursing; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010817:Physician-Patient Relations; D016896:Treatment Outcome; D014481:United States