title: Need and unmet need for care coordination among children with mental health conditions.
abstract: OBJECTIVE
  To determine prevalence and correlates of need and unmet need for care coordination in a national sample of children with mental health conditions.
  
  
  METHODS
  Using data from the 2007 National Survey of Children's Health, we identified children aged 2 to 17 years with ≥1 mental health condition (attention-deficit/hyperactivity disorder, anxiety disorder, conduct disorder, or depression) who had received ≥2 types of preventive or subspecialty health services in the past year. We defined 2 outcome measures of interest: (1) prevalence of need for care coordination; and (2) prevalence of unmet need for care coordination in those with a need. Logistic regression models were used to estimate associations of clinical, sociodemographic, parent psychosocial, and health care characteristics with the outcome measures.
  
  
  RESULTS
  In our sample (N = 7501, representing an estimated 5,750,000 children), the prevalence of having any need for care coordination was 43.2%. Among parents reporting a need for care coordination, the prevalence of unmet need was 41.2%. Higher risk of unmet need for care coordination was associated with child anxiety disorder, parenting stress, lower income, and public or no insurance. Parents reporting social support and receipt of family-centered care had a lower risk of unmet need for care coordination.
  
  
  CONCLUSIONS
  Approximately 40% of parents of children with mental health conditions who reported a need for care coordination also reported that their need was unmet. Delivery of family-centered care and enhancing family supports may help to reduce unmet need for care coordination in this vulnerable population.
authors.affiliation: Robert Wood Johnson Foundation Clinical Scholars Program and.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Brown
authors.forename: Jeremy C
authors.initials: JC
authors.lastname: Green
authors.forename: Mayur M
authors.initials: MM
authors.lastname: Desai
authors.forename: Carol C
authors.initials: CC
authors.lastname: Weitzman
authors.forename: Marjorie S
authors.initials: MS
authors.lastname: Rosenthal
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D008603:Mental Health / Q000706:statistics & numerical data; D020380:Needs Assessment / Q000706:statistics & numerical data
keywords: care coordination; family-centered care; health care delivery; medical home; mental health